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 $33.11 Median $33.11 Typical High $38.90 | Facility | None | $33.11 | $33.11 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $44.67 | Professional | None | $33.11 | $41.69 | $44.67 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $51.29 | Facility | None | $35.48 | $51.29 | $51.29 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $125.89 | Professional | None | $30.20 | $33.11 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | None | $40.74 | $44.67 | $44.67 |
Sanford Health Plan Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $37.15 | Professional | None | $30.90 | $33.11 | $37.15 |
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 $16.60 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $16.60 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.89 |
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· 10th of 51
$33.88
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.