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 $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $954.99 | Professional | None | $645.65 | $645.65 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $91.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,819.70 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $363.08 Typical High $426.58 | Professional | 55 · Aftercare only | $288.40 | $363.08 | $426.58 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $181.97 Typical High $213.80 | Professional | 56 · Pre-op care only | $144.54 | $181.97 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $2,041.74 | Professional | None | $724.44 | $1,445.44 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,949.84 | Facility | None | $645.65 | $645.65 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $5,370.32 | Professional | None | $645.65 | $1,122.02 | $5,370.32 |
United Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,380.38 | Professional | None | $602.56 | $954.99 | $1,380.38 |
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 $323.59 Median $323.59 Typical High $457.09 | Professional | 52 · Reduced service | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | 53 · Discontinued | $128.82 | $128.82 | $181.97 |
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· 5th 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.