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 $72.44 Median $74.13 Typical High $85.11 | Facility | None | $72.44 | $74.13 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $12.59 | Facility | 55 · Aftercare only | $10.72 | $11.22 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $85.11 | Professional | None | $72.44 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.30 Typical High $12.59 | Professional | 55 · Aftercare only | $10.72 | $12.30 | $12.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $186.21 | Professional | None | $117.49 | $141.25 | $186.21 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $141.25 Median $169.82 Typical High $223.87 | Professional | 22 · Increased work | $141.25 | $169.82 | $223.87 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $213.80 | Professional | None | $112.20 | $147.91 | $213.80 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $213.80 | Facility | None | $72.44 | $85.11 | $213.80 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $512.86 | Professional | None | $83.18 | $158.49 | $512.86 |
United Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $165.96 | Professional | None | $74.13 | $120.23 | $165.96 |
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 $36.31 Median $37.15 Typical High $41.69 | Facility | 52 · Reduced service | $36.31 | $37.15 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $16.98 | Facility | 53 · Discontinued | $14.45 | $14.79 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $8.51 | Facility | 56 · Pre-op care only | $7.24 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $40.74 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.60 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $8.32 | $8.51 |
Where North Dakota sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 3rd of 51
$138
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.