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 $26.30 Median $26.30 Typical High $28.84 | Facility | None | $26.30 | $26.30 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $36.31 | Professional | None | $26.30 | $30.90 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $25.70 | Professional | None | $8.91 | $11.22 | $25.70 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $54.95 Typical High $54.95 | Facility | None | $26.30 | $54.95 | $54.95 |
Medica Setting Professional Modifier None Typical Low $22.91 Median $31.62 Typical High $33.11 | Professional | None | $22.91 | $31.62 | $33.11 |
Midlands Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Midlands Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Sanford Health Plan Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $35.48 | Professional | None | $30.20 | $31.62 | $35.48 |
Wellmark Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Wellmark Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $13.18 Median $15.49 Typical High $18.20 | Professional | 52 · Reduced service | $13.18 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.17 Typical High $7.24 | Professional | 53 · Discontinued | $5.25 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.57 Typical High $5.37 | Professional | 55 · Aftercare only | $3.98 | $4.57 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.09 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.63 | $3.09 | $3.63 |
Where South Dakota sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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· 41st of 51
$30.20
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.