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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $616.60 | Professional | None | $457.09 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $93.33 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $61.66 |
BCBS North Dakota Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,445.44 | Professional | None | $977.24 | $1,230.27 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $194.98 | $245.47 | $288.40 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,412.54 | Professional | None | $512.86 | $1,000.00 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,380.38 | Facility | None | $457.09 | $457.09 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $3,715.35 | Professional | None | $457.09 | $794.33 | $3,715.35 |
United Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $977.24 | Professional | None | $426.58 | $676.08 | $977.24 |
2 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 $229.09 Median $229.09 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $91.20 | $123.03 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in New York. 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· 4th of 51
$1,000
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.