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 $30.90 Median $30.90 Typical High $38.02 | Facility | None | $30.90 | $30.90 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | None | $30.90 | $30.90 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $46.77 | Professional | None | $31.62 | $38.90 | $46.77 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $52.48 | Facility | None | $38.02 | $52.48 | $52.48 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $134.90 | Professional | None | $30.90 | $34.67 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | None | $39.81 | $46.77 | $46.77 |
Sanford Health Plan Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | None | $30.90 | $32.36 | $36.31 |
Wellmark Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Wellmark Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $15.49 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.59 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.80 |
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· 6th of 51
$34.67
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.