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 $69.18 Median $204.17 Typical High $204.17 | Facility | None | $69.18 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $30.20 | Facility | 55 · Aftercare only | $10.23 | $10.96 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $229.09 | Professional | None | $64.57 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.88 Typical High $30.20 | Professional | 55 · Aftercare only | $9.55 | $12.88 | $30.20 |
BCBS North Dakota Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $489.78 | Professional | None | $107.15 | $186.21 | $489.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $128.82 Median $218.78 Typical High $588.84 | Professional | 22 · Increased work | $128.82 | $218.78 | $588.84 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $37.15 Typical High $97.72 | Professional | 55 · Aftercare only | $21.38 | $37.15 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $181.97 Typical High $478.63 | Professional | None | $70.79 | $181.97 | $478.63 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $204.17 Typical High $602.56 | Facility | None | $69.18 | $204.17 | $602.56 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $512.86 Typical High $1,230.27 | Professional | None | $204.17 | $512.86 | $1,230.27 |
United Setting Professional Modifier None Typical Low $70.79 Median $173.78 Typical High $389.05 | Professional | None | $70.79 | $173.78 | $389.05 |
8 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 $34.67 Median $37.15 Typical High $102.33 | Facility | 52 · Reduced service | $34.67 | $37.15 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $40.74 | Facility | 53 · Discontinued | $13.80 | $14.79 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $54.95 Typical High $151.36 | Facility | 54 · Surgery only | $51.29 | $54.95 | $151.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $20.42 | Facility | 56 · Pre-op care only | $6.92 | $7.41 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $42.66 Typical High $102.33 | Professional | 52 · Reduced service | $32.36 | $42.66 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $17.38 Typical High $40.74 | Professional | 53 · Discontinued | $12.88 | $17.38 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $64.57 Typical High $151.36 | Professional | 54 · Surgery only | $47.86 | $64.57 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $20.42 |
Where North Dakota sits
The same service costs 2.9 times more in Washington than in Kentucky. 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
$204
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.