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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | None | $79.43 | $79.43 | $104.71 |
BCBS North Dakota Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $35.48 | Professional | None | $24.55 | $30.20 | $35.48 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $29.51 Median $36.31 Typical High $42.66 | Professional | 22 · Increased work | $29.51 | $36.31 | $42.66 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $7.08 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $7.08 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.02 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.45 | $3.02 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $218.78 | Professional | None | $87.10 | $158.49 | $218.78 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $794.33 | Facility | None | $79.43 | $128.82 | $794.33 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $575.44 | Professional | None | $81.28 | $134.90 | $575.44 |
United Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $165.96 | Professional | None | $74.13 | $109.65 | $165.96 |
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 $39.81 Median $39.81 Typical High $52.48 | Professional | 52 · Reduced service | $39.81 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $20.89 | Professional | 53 · Discontinued | $15.85 | $15.85 | $20.89 |
Where North Dakota sits
The same service costs 4.3 times more in Alaska than in Pennsylvania. 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· 48th of 51
$79.43
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.