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 $57.54 Median $57.54 Typical High $74.13 | Facility | None | $57.54 | $57.54 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $81.28 | Professional | None | $57.54 | $72.44 | $81.28 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $93.33 | Facility | None | $70.79 | $93.33 | $93.33 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $229.09 | Professional | None | $54.95 | $60.26 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | None | $70.79 | $81.28 | $81.28 |
Sanford Health Plan Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | None | $54.95 | $57.54 | $66.07 |
Wellmark Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Wellmark Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $28.84 Median $28.84 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 53 · Discontinued | $11.48 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $7.41 |
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· 10th of 51
$60.26
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.