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 $93.33 Median $512.86 Typical High $512.86 | Facility | None | $93.33 | $512.86 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $75.86 | Facility | 55 · Aftercare only | $14.13 | $14.79 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $204.17 Typical High $758.58 | Professional | None | $93.33 | $204.17 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $30.20 Typical High $112.20 | Professional | 55 · Aftercare only | $14.13 | $30.20 | $112.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $1,698.24 | Professional | None | $134.90 | $257.04 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $162.18 Median $309.03 Typical High $2,041.74 | Professional | 22 · Increased work | $162.18 | $309.03 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $51.29 Typical High $338.84 | Professional | 55 · Aftercare only | $26.92 | $51.29 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $1,659.59 | Professional | None | $131.83 | $263.03 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $281.84 Typical High $954.99 | Facility | None | $93.33 | $281.84 | $954.99 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $4,677.35 | Professional | None | $309.03 | $512.86 | $4,677.35 |
United Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $977.24 | Professional | None | $100.00 | $239.88 | $977.24 |
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 $46.77 Median $48.98 Typical High $257.04 | Facility | 52 · Reduced service | $46.77 | $48.98 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $102.33 | Facility | 53 · Discontinued | $18.62 | $19.95 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $74.13 Typical High $380.19 | Facility | 54 · Surgery only | $69.18 | $74.13 | $380.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $51.29 | Facility | 56 · Pre-op care only | $9.33 | $10.00 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $102.33 Typical High $380.19 | Professional | 52 · Reduced service | $46.77 | $102.33 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $40.74 Typical High $151.36 | Professional | 53 · Discontinued | $18.62 | $40.74 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $151.36 Typical High $562.34 | Professional | 54 · Surgery only | $69.18 | $151.36 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $20.42 Typical High $75.86 | Professional | 56 · Pre-op care only | $9.33 | $20.42 | $75.86 |
Where North Dakota sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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
$398
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.