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 $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $61.66 | Professional | None | $46.77 | $52.48 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $13.49 | Professional | None | $9.12 | $11.22 | $13.49 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $93.33 Typical High $93.33 | Facility | None | $26.92 | $93.33 | $93.33 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $407.38 | Professional | None | $42.66 | $56.23 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Midlands Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Sanford Health Plan Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $60.26 | Professional | None | $50.12 | $52.48 | $60.26 |
Wellmark Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Wellmark Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $23.44 Median $25.70 Typical High $30.90 | Professional | 52 · Reduced service | $23.44 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $12.30 | Professional | 53 · Discontinued | $9.33 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.76 Typical High $9.12 | Professional | 55 · Aftercare only | $7.08 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $6.17 |
Where South Dakota sits
The same service costs 6.6 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· 33rd of 51
$50.12
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.