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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $25.12 Typical High $25.12 | Professional | None | $15.49 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $28.84 | Professional | None | $22.91 | $22.91 | $28.84 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $42.66 Typical High $42.66 | Facility | None | $25.70 | $42.66 | $42.66 |
Medica Setting Professional Modifier None Typical Low $7.94 Median $10.23 Typical High $147.91 | Professional | None | $7.94 | $10.23 | $147.91 |
Sanford Health Plan Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.90 | Professional | None | $25.70 | $25.70 | $30.90 |
United Setting Professional Modifier None Typical Low $7.59 Median $7.94 Typical High $12.88 | Professional | None | $7.59 | $7.94 | $12.88 |
Wellmark Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
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 $7.76 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $7.76 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $3.09 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $2.34 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.55 | $2.51 | $2.51 |
Where South Dakota sits
The same service costs 4.2 times more in Hawaii than in New York. 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· 7th of 51
$20.42
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.