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 $29.51 Median $30.20 Typical High $85.11 | Facility | None | $29.51 | $30.20 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $12.59 | Facility | 55 · Aftercare only | $4.47 | $4.47 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $85.11 Typical High $141.25 | Professional | None | $29.51 | $85.11 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $4.47 | $10.72 | $13.18 |
BCBS North Dakota Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $204.17 | Professional | None | $46.77 | $81.28 | $204.17 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $56.23 Median $97.72 Typical High $245.47 | Professional | 22 · Increased work | $56.23 | $97.72 | $245.47 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.22 Typical High $40.74 | Professional | 55 · Aftercare only | $9.55 | $16.22 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $229.09 | Facility | None | $199.53 | $199.53 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $87.10 Typical High $199.53 | Professional | None | $39.81 | $87.10 | $199.53 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $85.11 Typical High $144.54 | Facility | None | $29.51 | $85.11 | $144.54 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $588.84 | Professional | None | $85.11 | $165.96 | $588.84 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $165.96 | Professional | None | $28.84 | $70.79 | $165.96 |
6 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 $14.79 Median $15.14 Typical High $41.69 | Facility | 52 · Reduced service | $14.79 | $15.14 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $16.98 | Facility | 53 · Discontinued | $5.89 | $6.03 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $8.51 | Facility | 56 · Pre-op care only | $2.95 | $3.02 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $35.48 Typical High $44.67 | Professional | 52 · Reduced service | $14.79 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $14.13 Typical High $17.78 | Professional | 53 · Discontinued | $5.89 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $7.08 Typical High $8.91 | Professional | 56 · Pre-op care only | $2.95 | $7.08 | $8.91 |
Where North Dakota sits
The same service costs 3.6 times more in North Carolina 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· 16th of 51
$85.11
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.