How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $30.90 | Facility | None | $11.48 | $11.48 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $30.90 | Professional | None | $11.48 | $11.48 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $17.78 | Professional | None | $11.75 | $14.79 | $17.78 |
Medica Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $30.90 | Facility | None | $20.42 | $20.42 | $30.90 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $89.13 | Professional | None | $12.02 | $13.49 | $89.13 |
Midlands Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Midlands Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Sanford Health Plan Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $16.60 | Professional | None | $13.80 | $14.79 | $16.60 |
Wellmark Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Wellmark Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $5.75 Typical High $15.49 | Professional | 52 · Reduced service | $5.75 | $5.75 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $6.31 | Professional | 53 · Discontinued | $2.29 | $2.29 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $4.68 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $3.09 |
Where South Dakota sits
The same service costs 1.8 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Dakota· 7th of 51
$15.14
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.