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 $24.55 Median $40.74 Typical High $40.74 | Facility | None | $24.55 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.63 Median $3.72 Typical High $6.03 | Facility | 55 · Aftercare only | $3.63 | $3.72 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $40.74 | Professional | None | $24.55 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.17 Typical High $6.03 | Professional | 55 · Aftercare only | $3.63 | $4.17 | $6.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $95.50 | Professional | None | $38.90 | $58.88 | $95.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $46.77 Median $70.79 Typical High $114.82 | Professional | 22 · Increased work | $46.77 | $70.79 | $114.82 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.75 Typical High $19.05 | Professional | 55 · Aftercare only | $7.94 | $11.75 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $34.67 Typical High $85.11 | Professional | None | $15.49 | $34.67 | $85.11 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $40.74 Typical High $72.44 | Facility | None | $24.55 | $40.74 | $72.44 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $245.47 | Professional | None | $34.67 | $52.48 | $245.47 |
United Setting Professional Modifier None Typical Low $21.38 Median $35.48 Typical High $61.66 | Professional | None | $21.38 | $35.48 | $61.66 |
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 $12.30 Median $12.59 Typical High $20.42 | Facility | 52 · Reduced service | $12.30 | $12.59 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $8.13 | Facility | 53 · Discontinued | $4.90 | $5.01 | $8.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $4.07 | Facility | 56 · Pre-op care only | $2.45 | $2.51 | $4.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $13.80 Typical High $20.42 | Professional | 52 · Reduced service | $12.30 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.62 Typical High $8.13 | Professional | 53 · Discontinued | $4.90 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.75 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.45 | $2.75 | $4.07 |
Where North Dakota sits
The same service costs 2.7 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· 10th of 51
$40.74
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.