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 $1,258.93 Median $1,258.93 Typical High $1,479.11 | Facility | None | $1,258.93 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,584.89 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,479.11 | $2,344.23 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $6,165.95 | Professional | None | $1,380.38 | $1,548.82 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,698.24 | $2,041.74 | $2,041.74 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,380.38 | $1,445.44 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,348.96 | $1,513.56 |
Wellmark Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $616.60 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
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
$1,413
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.