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 $38.02 Median $38.02 Typical High $61.66 | Facility | None | $38.02 | $38.02 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $61.66 | Professional | None | $38.02 | $38.02 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $54.95 | Professional | None | $38.90 | $48.98 | $54.95 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $66.07 | Facility | None | $56.23 | $63.10 | $66.07 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $54.95 | Professional | None | $37.15 | $41.69 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | None | $47.86 | $54.95 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Sanford Health Plan Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $46.77 | Professional | None | $39.81 | $41.69 | $46.77 |
Wellmark Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Wellmark Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $19.05 Median $19.05 Typical High $30.90 | Professional | 52 · Reduced service | $19.05 | $19.05 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $12.30 | Professional | 53 · Discontinued | $7.59 | $7.59 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $9.33 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $6.17 |
Where South Dakota sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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· 9th of 51
$43.65
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.