How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $30.20 Median $102.33 Typical High $102.33 | Facility | None | $30.20 | $102.33 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $75.86 | Facility | 54 · Surgery only | $22.91 | $22.91 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $48.98 Typical High $120.23 | Professional | None | $28.84 | $48.98 | $120.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $245.47 | Professional | None | $57.54 | $85.11 | $245.47 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $69.18 Median $102.33 Typical High $295.12 | Professional | 22 · Increased work | $69.18 | $102.33 | $295.12 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $60.26 Typical High $173.78 | Professional | 54 · Surgery only | $39.81 | $60.26 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $204.17 | Facility | None | $177.83 | $177.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $275.42 | Professional | None | $44.67 | $102.33 | $275.42 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $102.33 Typical High $269.15 | Facility | None | $30.20 | $102.33 | $269.15 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $218.78 | Professional | None | $102.33 | $194.98 | $218.78 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $31.62 Median $83.18 Typical High $213.80 | Professional | None | $31.62 | $83.18 | $213.80 |
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 Facility Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $51.29 | Facility | 52 · Reduced service | $15.14 | $15.14 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $20.42 | Facility | 53 · Discontinued | $6.03 | $6.03 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $15.14 | Facility | 55 · Aftercare only | $4.57 | $4.57 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $10.23 | Facility | 56 · Pre-op care only | $3.02 | $3.02 | $10.23 |
Where North Dakota sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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.
North Dakota· 27th of 51
$102
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.