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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $33.11 Typical High $33.11 | Professional | None | $28.18 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $53.70 | Professional | None | $42.66 | $42.66 | $53.70 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $56.23 Typical High $56.23 | Facility | None | $45.71 | $56.23 | $56.23 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $14.13 Typical High $389.05 | Professional | None | $13.80 | $14.13 | $389.05 |
Sanford Health Plan Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | None | $33.88 | $33.88 | $41.69 |
United Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $20.89 | Professional | None | $13.49 | $13.80 | $20.89 |
Wellmark Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
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 $14.13 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $14.13 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $5.75 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.27 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.82 | $3.39 | $3.39 |
Where South Dakota sits
The same service costs 5.9 times more in Hawaii than in Utah. 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· 19th of 51
$28.18
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.