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 $50.12 Median $56.23 Typical High $75.86 | Facility | None | $50.12 | $56.23 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $109.65 | Professional | None | $47.86 | $64.57 | $109.65 |
BCBS North Dakota Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $47.86 Typical High $74.13 | Professional | 53 · Discontinued | $33.88 | $47.86 | $74.13 |
BCBS North Dakota Setting Professional Modifier AF · Specialist physician Typical Low $69.18 Median $95.50 Typical High $147.91 | Professional | AF · Specialist physician | $69.18 | $95.50 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $173.78 | Professional | None | $69.18 | $120.23 | $173.78 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $151.36 | Facility | None | $50.12 | $75.86 | $151.36 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $457.09 | Professional | None | $69.18 | $138.04 | $457.09 |
United Setting Professional Modifier None Typical Low $50.12 Median $83.18 Typical High $147.91 | Professional | None | $50.12 | $83.18 | $147.91 |
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 $25.12 Median $25.12 Typical High $38.02 | Facility | 52 · Reduced service | $25.12 | $25.12 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $11.22 | Facility | 55 · Aftercare only | $7.41 | $7.41 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $7.59 | Facility | 56 · Pre-op care only | $5.01 | $5.01 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $27.54 Typical High $38.02 | Professional | 52 · Reduced service | $24.55 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.32 Typical High $11.22 | Professional | 55 · Aftercare only | $7.41 | $8.32 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.50 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.90 | $5.50 | $7.59 |
Where North Dakota sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 15th of 51
$77.62
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.