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 $36.31 Median $36.31 Typical High $56.23 | Facility | None | $36.31 | $36.31 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | None | $36.31 | $36.31 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $54.95 | Professional | None | $37.15 | $46.77 | $54.95 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $63.10 | Facility | None | $52.48 | $63.10 | $63.10 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $165.96 | Professional | None | $37.15 | $40.74 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | None | $47.86 | $54.95 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Sanford Health Plan Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $43.65 | Professional | None | $36.31 | $38.02 | $43.65 |
Wellmark Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Wellmark Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $18.20 Median $18.20 Typical High $28.18 | Professional | 52 · Reduced service | $18.20 | $18.20 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $11.22 | Professional | 53 · Discontinued | $7.24 | $7.24 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $8.51 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $5.62 |
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· 8th of 51
$40.74
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.