How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $5.89 Median $8.51 Typical High $45.71 | Facility | None | $5.89 | $8.51 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.23 | Professional | None | $8.13 | $8.13 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $10.47 | Professional | None | $6.46 | $8.32 | $10.47 |
Medica Setting Facility Modifier None Typical Low $4.37 Median $9.12 Typical High $30.90 | Facility | None | $4.37 | $9.12 | $30.90 |
Medica Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $48.98 | Professional | None | $5.37 | $5.89 | $48.98 |
Midlands Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $8.71 | Professional | None | $6.46 | $6.46 | $8.71 |
Midlands Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Sanford Health Plan Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | None | $7.24 | $7.24 | $7.94 |
Wellmark Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Wellmark Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $4.07 Median $4.07 Typical High $5.13 | Professional | 52 · Reduced service | $4.07 | $4.07 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $2.04 | Professional | 53 · Discontinued | $1.62 | $1.62 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.51 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $1.02 |
Where South Dakota sits
Rates are fairly even across states for this service. 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· 50th of 51
$7.24
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.