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 $56.23 Median $56.23 Typical High $69.18 | Facility | None | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | None | $56.23 | $56.23 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $75.86 | Professional | None | $57.54 | $72.44 | $75.86 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $85.11 | Facility | None | $61.66 | $85.11 | $85.11 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $218.78 | Professional | None | $50.12 | $56.23 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | None | $69.18 | $75.86 | $75.86 |
Sanford Health Plan Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $63.10 | Professional | None | $53.70 | $56.23 | $63.10 |
Wellmark Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Wellmark Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $28.18 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.92 |
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· 9th of 51
$58.88
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.