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 $0.12 Median $0.12 Typical High $0.13 | Facility | None | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.13 Typical High $0.15 | Professional | None | $0.12 | $0.13 | $0.15 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.47 Typical High $3.24 | Professional | None | $0.38 | $0.47 | $3.24 |
Medica Setting Facility Modifier None Typical Low $0.11 Median $0.19 Typical High $0.30 | Facility | None | $0.11 | $0.19 | $0.30 |
Medica Setting Professional Modifier None Typical Low $0.10 Median $0.11 Typical High $61.66 | Professional | None | $0.10 | $0.11 | $61.66 |
Midlands Setting Professional Modifier None Typical Low $3.02 Median $3.24 Typical High $3.24 | Professional | None | $3.02 | $3.24 | $3.24 |
Midlands Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Sanford Health Plan Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | None | $0.13 | $0.13 | $0.14 |
Wellmark Setting Facility Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Facility | None | $0.13 | $0.13 | $0.13 |
Wellmark Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
3 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 $0.06 Median $0.07 Typical High $0.08 | Professional | 52 · Reduced service | $0.06 | $0.07 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where South Dakota sits
The same service costs 32.4 times more in Montana 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· 6th of 51
$0.14
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.