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 $63.10 Median $123.03 Typical High $123.03 | Facility | None | $63.10 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $18.62 | Facility | 55 · Aftercare only | $9.55 | $10.23 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $123.03 | Professional | None | $63.10 | $72.44 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $18.62 | Professional | 55 · Aftercare only | $9.55 | $10.72 | $18.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $263.03 | Professional | None | $97.72 | $158.49 | $263.03 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $117.49 Median $190.55 Typical High $316.23 | Professional | 22 · Increased work | $117.49 | $190.55 | $316.23 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $31.62 Typical High $53.70 | Professional | 55 · Aftercare only | $19.50 | $31.62 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $269.15 | Professional | None | $42.66 | $102.33 | $269.15 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $208.93 | Facility | None | $63.10 | $123.03 | $208.93 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $776.25 | Professional | None | $100.00 | $154.88 | $776.25 |
United Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $154.88 | Professional | None | $38.02 | $97.72 | $154.88 |
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 $31.62 Median $33.88 Typical High $61.66 | Facility | 52 · Reduced service | $31.62 | $33.88 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $24.55 | Facility | 53 · Discontinued | $12.59 | $13.49 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $12.30 | Facility | 56 · Pre-op care only | $6.31 | $6.76 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $36.31 Typical High $61.66 | Professional | 52 · Reduced service | $31.62 | $36.31 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.45 Typical High $24.55 | Professional | 53 · Discontinued | $12.59 | $14.45 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.24 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.31 | $7.24 | $12.30 |
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· 7th of 51
$115
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.