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 $75.86 Median $173.78 Typical High $181.97 | Facility | None | $75.86 | $173.78 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $26.92 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $169.82 Typical High $181.97 | Professional | None | $64.57 | $169.82 | $181.97 |
BCBS North Dakota Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $363.08 | Professional | None | $93.33 | $151.36 | $363.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $112.20 Median $181.97 Typical High $436.52 | Professional | 22 · Increased work | $112.20 | $181.97 | $436.52 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $72.44 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Facility | None | $269.15 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $426.58 | Professional | None | $97.72 | $194.98 | $426.58 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $181.97 Typical High $309.03 | Facility | None | $75.86 | $181.97 | $309.03 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $389.05 | Professional | None | $181.97 | $323.59 | $389.05 |
United Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $346.74 | Professional | None | $75.86 | $162.18 | $346.74 |
4 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 $38.02 Median $38.02 Typical High $91.20 | Facility | 52 · Reduced service | $38.02 | $38.02 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $36.31 | Facility | 53 · Discontinued | $15.14 | $15.14 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $134.90 | Facility | 54 · Surgery only | $56.23 | $56.23 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $18.20 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $18.20 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$182
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.