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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | None | $66.07 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $11.75 |
BCBS Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $169.82 | Professional | None | $109.65 | $144.54 | $169.82 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $131.83 Median $173.78 Typical High $204.17 | Professional | 22 · Increased work | $131.83 | $173.78 | $204.17 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $194.98 | Professional | None | $125.89 | $154.88 | $194.98 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $199.53 | Facility | None | $66.07 | $66.07 | $199.53 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $407.38 | Professional | None | $66.07 | $109.65 | $407.38 |
United Setting Professional Modifier None Typical Low $60.26 Median $109.65 Typical High $117.49 | Professional | None | $60.26 | $109.65 | $117.49 |
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 $33.11 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | 53 · Discontinued | $13.18 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.76 |
Where North Dakota sits
The same service costs 3.2 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· 2nd of 51
$129
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.