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 $100.00 Median $102.33 Typical High $128.82 | Facility | None | $100.00 | $102.33 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $19.50 | Facility | 55 · Aftercare only | $14.79 | $15.49 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $12.88 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $128.82 | Professional | None | $91.20 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $12.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $281.84 | Professional | None | $151.36 | $208.93 | $281.84 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $56.23 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $56.23 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.14 | $20.89 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $275.42 | Professional | None | $64.57 | $109.65 | $275.42 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $295.12 | Facility | None | $100.00 | $128.82 | $295.12 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $794.33 | Professional | None | $114.82 | $173.78 | $794.33 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $213.80 | Professional | None | $85.11 | $114.82 | $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 $48.98 Median $51.29 Typical High $64.57 | Facility | 52 · Reduced service | $48.98 | $51.29 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $26.30 | Facility | 53 · Discontinued | $19.95 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $51.29 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $26.30 | Professional | 53 · Discontinued | $18.20 | $20.42 | $26.30 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 8th of 51
$151
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.