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 $58.88 Median $58.88 Typical High $93.33 | Facility | None | $58.88 | $58.88 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $93.33 | Professional | None | $58.88 | $58.88 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $95.50 | Professional | None | $58.88 | $74.13 | $95.50 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $107.15 | Facility | None | $89.13 | $107.15 | $107.15 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $302.00 | Professional | None | $63.10 | $70.79 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | None | $79.43 | $95.50 | $95.50 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $70.79 | Professional | None | $60.26 | $63.10 | $70.79 |
Wellmark Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Wellmark Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
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 $28.84 Median $28.84 Typical High $46.77 | Professional | 52 · Reduced service | $28.84 | $28.84 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $18.62 | Professional | 53 · Discontinued | $11.75 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $14.13 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $9.33 |
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
$66.07
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.