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 $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $37.15 | Professional | None | $28.84 | $31.62 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $33.11 Typical High $41.69 | Professional | None | $17.38 | $33.11 | $41.69 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $56.23 Typical High $56.23 | Facility | None | $28.84 | $56.23 | $56.23 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $32.36 Typical High $33.88 | Professional | None | $17.38 | $32.36 | $33.88 |
Midlands Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $19.50 | Professional | None | $17.38 | $17.38 | $19.50 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Sanford Health Plan Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | None | $30.90 | $32.36 | $36.31 |
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 $14.45 Median $15.85 Typical High $18.62 | Professional | 52 · Reduced service | $14.45 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.31 Typical High $7.41 | Professional | 53 · Discontinued | $5.75 | $6.31 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.68 Typical High $5.50 | Professional | 55 · Aftercare only | $4.37 | $4.68 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.16 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.88 | $3.16 | $3.72 |
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· 40th of 51
$31.62
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.