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 $21.88 Median $22.91 Typical High $79.43 | Facility | None | $21.88 | $22.91 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.24 Median $3.47 Typical High $12.02 | Facility | 55 · Aftercare only | $3.24 | $3.47 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $79.43 | Professional | None | $21.88 | $25.12 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.80 Typical High $12.02 | Professional | 55 · Aftercare only | $3.24 | $3.80 | $12.02 |
BCBS North Dakota Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $186.21 | Professional | None | $35.48 | $53.70 | $186.21 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $42.66 Median $64.57 Typical High $223.87 | Professional | 22 · Increased work | $42.66 | $64.57 | $223.87 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.72 Typical High $37.15 | Professional | 55 · Aftercare only | $7.08 | $10.72 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $58.88 Typical High $177.83 | Professional | None | $14.45 | $58.88 | $177.83 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $66.07 Typical High $134.90 | Facility | None | $21.88 | $66.07 | $134.90 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $524.81 | Professional | None | $63.10 | $97.72 | $524.81 |
United Setting Professional Modifier None Typical Low $18.62 Median $38.02 Typical High $102.33 | Professional | None | $18.62 | $38.02 | $102.33 |
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 $10.96 Median $11.48 Typical High $39.81 | Facility | 52 · Reduced service | $10.96 | $11.48 | $39.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $4.68 Typical High $15.85 | Facility | 53 · Discontinued | $4.37 | $4.68 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.29 Typical High $7.94 | Facility | 56 · Pre-op care only | $2.19 | $2.29 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.59 Typical High $39.81 | Professional | 52 · Reduced service | $10.96 | $12.59 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $5.01 Typical High $15.85 | Professional | 53 · Discontinued | $4.37 | $5.01 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.51 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.19 | $2.51 | $7.94 |
Where North Dakota sits
The same service costs 4.4 times more in Hawaii than in Washington, DC. 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· 11th of 51
$63.10
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.