How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.20 | Professional | None | $26.30 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.47 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.47 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $57.54 Median $75.86 Typical High $79.43 | Professional | 22 · Increased work | $57.54 | $75.86 | $79.43 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $72.44 | Professional | None | $40.74 | $58.88 | $72.44 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $79.43 | Facility | None | $26.30 | $26.30 | $79.43 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $48.98 Typical High $239.88 | Professional | None | $26.92 | $48.98 | $239.88 |
United Setting Professional Modifier None Typical Low $26.92 Median $44.67 Typical High $54.95 | Professional | None | $26.92 | $44.67 | $54.95 |
3 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 Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.18 Typical High $15.14 | Professional | 52 · Reduced service | $13.18 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $6.03 | Professional | 53 · Discontinued | $5.25 | $5.25 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.02 |
Where North Dakota sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 13th of 51
$44.67
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.