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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $91.20 | Professional | None | $74.13 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $128.82 | Professional | None | $102.33 | $102.33 | $128.82 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $154.88 | Facility | None | $120.23 | $154.88 | $154.88 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $489.78 | Professional | None | $32.36 | $37.15 | $489.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
United Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $46.77 | Professional | None | $30.20 | $32.36 | $46.77 |
Wellmark Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $37.15 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $37.15 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $14.79 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.41 | $9.12 | $9.12 |
Where South Dakota sits
The same service costs 3.0 times more in Hawaii 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· 12th of 51
$74.13
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.