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 $54.95 Median $56.23 Typical High $107.15 | Facility | None | $54.95 | $56.23 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $15.85 | Facility | 55 · Aftercare only | $8.32 | $8.51 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $107.15 | Professional | None | $54.95 | $61.66 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.33 Typical High $15.85 | Professional | 55 · Aftercare only | $8.32 | $9.33 | $15.85 |
BCBS North Dakota Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $234.42 | Professional | None | $83.18 | $131.83 | $234.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $100.00 Median $154.88 Typical High $275.42 | Professional | 22 · Increased work | $100.00 | $154.88 | $275.42 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.30 Typical High $46.77 | Professional | 55 · Aftercare only | $16.60 | $26.30 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $85.11 Typical High $223.87 | Professional | None | $35.48 | $85.11 | $223.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $107.15 Typical High $181.97 | Facility | None | $54.95 | $107.15 | $181.97 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $676.08 | Professional | None | $87.10 | $131.83 | $676.08 |
United Setting Professional Modifier None Typical Low $38.02 Median $83.18 Typical High $128.82 | Professional | None | $38.02 | $83.18 | $128.82 |
6 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 $27.54 Median $28.18 Typical High $52.48 | Facility | 52 · Reduced service | $27.54 | $28.18 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $21.38 | Facility | 53 · Discontinued | $10.96 | $11.22 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $10.72 | Facility | 56 · Pre-op care only | $5.50 | $5.62 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $30.90 Typical High $52.48 | Professional | 52 · Reduced service | $27.54 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.59 Typical High $21.38 | Professional | 53 · Discontinued | $10.96 | $12.59 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.17 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.50 | $6.17 | $10.72 |
Where North Dakota sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 6th of 51
$97.72
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.