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 $144.54 Median $144.54 Typical High $169.82 | Facility | None | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | None | $144.54 | $144.54 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $204.17 | Professional | None | $147.91 | $181.97 | $204.17 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $229.09 | Facility | None | $158.49 | $229.09 | $229.09 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $588.84 | Professional | None | $134.90 | $151.36 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | None | $165.96 | $204.17 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Sanford Health Plan Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $162.18 | Professional | None | $138.04 | $144.54 | $162.18 |
Wellmark Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $72.44 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $28.84 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.98 |
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
$151
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.