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 $33.88 Median $33.88 Typical High $158.49 | Facility | None | $33.88 | $33.88 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $158.49 | Professional | None | $33.88 | $33.88 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $43.65 | Professional | None | $34.67 | $42.66 | $43.65 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $165.96 | Facility | None | $47.86 | $47.86 | $165.96 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $42.66 | Professional | None | $28.18 | $31.62 | $42.66 |
Midlands Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $42.66 | Professional | None | $33.88 | $42.66 | $42.66 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $190.55 | Professional | None | $37.15 | $37.15 | $190.55 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $33.88 | Professional | None | $28.18 | $30.20 | $33.88 |
Wellmark Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Wellmark Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $16.98 Median $16.98 Typical High $79.43 | Professional | 52 · Reduced service | $16.98 | $16.98 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $31.62 | Professional | 53 · Discontinued | $6.76 | $6.76 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $23.44 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $15.85 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $15.85 |
Where South Dakota sits
The same service costs 5.4 times more in Wyoming than in Arizona. 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· 34th of 51
$33.88
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.