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 $67.61 Median $151.36 Typical High $151.36 | Facility | None | $67.61 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $22.39 | Facility | 55 · Aftercare only | $10.00 | $10.72 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $151.36 | Professional | None | $63.10 | $85.11 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.88 Typical High $23.99 | Professional | 55 · Aftercare only | $9.55 | $12.88 | $23.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $371.54 | Professional | None | $107.15 | $181.97 | $371.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $128.82 Median $218.78 Typical High $446.68 | Professional | 22 · Increased work | $128.82 | $218.78 | $446.68 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $36.31 Typical High $74.13 | Professional | 55 · Aftercare only | $21.38 | $36.31 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $380.19 | Professional | None | $69.18 | $162.18 | $380.19 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $151.36 Typical High $257.04 | Facility | None | $67.61 | $151.36 | $257.04 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $436.52 Typical High $933.25 | Professional | None | $151.36 | $436.52 | $933.25 |
United Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $288.40 | Professional | None | $69.18 | $151.36 | $288.40 |
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 $33.88 Median $36.31 Typical High $75.86 | Facility | 52 · Reduced service | $33.88 | $36.31 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $30.20 | Facility | 53 · Discontinued | $13.49 | $14.45 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $50.12 Median $53.70 Typical High $112.20 | Facility | 54 · Surgery only | $50.12 | $53.70 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $15.14 | Facility | 56 · Pre-op care only | $6.76 | $7.24 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $42.66 Typical High $81.28 | Professional | 52 · Reduced service | $31.62 | $42.66 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.98 Typical High $32.36 | Professional | 53 · Discontinued | $12.59 | $16.98 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $120.23 | Professional | 54 · Surgery only | $47.86 | $63.10 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.51 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.31 | $8.51 | $16.22 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska 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· 12th of 51
$162
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.