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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $57.54 | Professional | None | $47.86 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | None | $74.13 | $74.13 | $93.33 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $97.72 Typical High $97.72 | Facility | None | $39.81 | $97.72 | $97.72 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $371.54 | Professional | None | $23.44 | $24.55 | $371.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | None | $58.88 | $58.88 | $70.79 |
United Setting Professional Modifier None Typical Low $10.96 Median $23.44 Typical High $36.31 | Professional | None | $10.96 | $23.44 | $36.31 |
Wellmark Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
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 $23.99 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $23.99 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $9.55 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.08 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.79 | $5.75 | $5.75 |
Where South Dakota sits
The same service costs 2.6 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· 22nd of 51
$47.86
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.