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 $9.55 Median $9.55 Typical High $14.79 | Facility | None | $9.55 | $9.55 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $14.79 | Professional | None | $9.55 | $9.55 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $12.02 | Professional | None | $9.77 | $11.75 | $12.02 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $13.18 Typical High $13.49 | Facility | None | $10.96 | $13.18 | $13.49 |
Medica Setting Professional Modifier None Typical Low $7.94 Median $8.71 Typical High $11.75 | Professional | None | $7.94 | $8.71 | $11.75 |
Midlands Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $11.75 | Professional | None | $9.77 | $11.75 | $11.75 |
Midlands Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Sanford Health Plan Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $45.71 | Professional | None | $10.47 | $10.47 | $45.71 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $9.55 | Professional | None | $8.13 | $8.51 | $9.55 |
Wellmark Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Wellmark Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
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 $4.79 Median $4.79 Typical High $7.41 | Professional | 52 · Reduced service | $4.79 | $4.79 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $2.95 | Professional | 53 · Discontinued | $1.91 | $1.91 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $2.19 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.48 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.48 |
Where South Dakota sits
The same service costs 1.7 times more in Wyoming than in North 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· 46th of 51
$9.55
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.