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 $85.11 Median $85.11 Typical High $97.72 | Facility | None | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | None | $85.11 | $85.11 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $123.03 | Professional | None | $87.10 | $109.65 | $123.03 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $138.04 | Facility | None | $93.33 | $138.04 | $138.04 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $338.84 | Professional | None | $81.28 | $91.20 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | None | $107.15 | $123.03 | $123.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $91.20 | Professional | None | $81.28 | $85.11 | $91.20 |
Wellmark Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
3 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 $42.66 Median $42.66 Typical High $48.98 | Professional | 52 · Reduced service | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $14.79 |
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· 7th of 51
$91.20
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.