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 $331.13 Median $331.13 Typical High $380.19 | Facility | None | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | None | $331.13 | $331.13 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $478.63 | Professional | None | $338.84 | $416.87 | $478.63 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $537.03 | Facility | None | $363.08 | $537.03 | $537.03 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $1,380.38 | Professional | None | $316.23 | $354.81 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | None | $416.87 | $478.63 | $478.63 |
Sanford Health Plan Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $380.19 | Professional | None | $323.59 | $338.84 | $380.19 |
Wellmark Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $165.96 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $38.02 |
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· 7th of 51
$355
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.