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 $8.13 Median $8.13 Typical High $41.69 | Facility | None | $8.13 | $8.13 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $41.69 | Professional | None | $8.13 | $8.13 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $14.45 | Professional | None | $8.32 | $10.47 | $14.45 |
Medica Setting Facility Modifier None Typical Low $13.80 Median $16.60 Typical High $41.69 | Facility | None | $13.80 | $16.60 | $41.69 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $14.45 | Professional | None | $9.77 | $10.72 | $14.45 |
Midlands Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $14.45 | Professional | None | $10.47 | $14.45 | $14.45 |
Midlands Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Sanford Health Plan Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $10.47 | Professional | None | $8.71 | $9.12 | $10.47 |
Wellmark Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Wellmark Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $4.07 Median $4.07 Typical High $20.89 | Professional | 52 · Reduced service | $4.07 | $4.07 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $8.32 | Professional | 53 · Discontinued | $1.62 | $1.62 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $6.31 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $4.17 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $4.17 |
Where South Dakota sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 10th of 51
$9.77
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.