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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $48.98 | Professional | None | $33.11 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | None | $54.95 | $54.95 | $67.61 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $83.18 Typical High $83.18 | Facility | None | $28.18 | $83.18 | $83.18 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $263.03 | Professional | None | $16.98 | $19.95 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | None | $50.12 | $50.12 | $61.66 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.98 Typical High $32.36 | Professional | None | $10.96 | $16.98 | $32.36 |
Wellmark Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $16.60 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $16.60 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $6.61 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $5.01 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.31 | $4.90 | $4.90 |
Where South Dakota sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 18th of 51
$34.67
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.