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 $45.71 Median $46.77 Typical High $128.82 | Facility | None | $45.71 | $46.77 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $19.50 | Facility | 55 · Aftercare only | $6.92 | $6.92 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $128.82 Typical High $173.78 | Professional | None | $45.71 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $6.92 | $16.60 | $20.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $323.59 | Professional | None | $74.13 | $125.89 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $89.13 Median $151.36 Typical High $389.05 | Professional | 22 · Increased work | $89.13 | $151.36 | $389.05 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $25.12 Typical High $64.57 | Professional | 55 · Aftercare only | $14.79 | $25.12 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $346.74 | Facility | None | $302.00 | $302.00 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $131.83 Typical High $309.03 | Professional | None | $61.66 | $131.83 | $309.03 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $128.82 Typical High $218.78 | Facility | None | $45.71 | $128.82 | $218.78 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $851.14 | Professional | None | $128.82 | $239.88 | $851.14 |
United Setting Professional Modifier None Typical Low $43.65 Median $109.65 Typical High $239.88 | Professional | None | $43.65 | $109.65 | $239.88 |
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 $22.91 Median $23.44 Typical High $64.57 | Facility | 52 · Reduced service | $22.91 | $23.44 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $25.70 | Facility | 53 · Discontinued | $9.33 | $9.33 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $12.88 | Facility | 56 · Pre-op care only | $4.57 | $4.68 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $22.91 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $9.33 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.57 | $10.96 | $13.49 |
Where North Dakota sits
The same service costs 3.5 times more in Wisconsin 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· 19th 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.