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 $123.03 Median $128.82 Typical High $162.18 | Facility | None | $123.03 | $128.82 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $245.47 | Professional | None | $120.23 | $138.04 | $245.47 |
BCBS North Dakota Setting Facility Modifier None Typical Low $316.23 Median $363.08 Typical High $416.87 | Facility | None | $316.23 | $363.08 | $416.87 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $128.82 Typical High $173.78 | Professional | 53 · Discontinued | $97.72 | $128.82 | $173.78 |
BCBS North Dakota Setting Professional Modifier AF · Specialist physician Typical Low $194.98 Median $257.04 Typical High $346.74 | Professional | AF · Specialist physician | $194.98 | $257.04 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $416.87 | Professional | None | $173.78 | $281.84 | $416.87 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $380.19 | Facility | None | $128.82 | $162.18 | $380.19 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $831.76 | Professional | None | $165.96 | $316.23 | $831.76 |
United Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $323.59 | Professional | None | $125.89 | $194.98 | $323.59 |
7 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 $64.57 Median $64.57 Typical High $81.28 | Facility | 52 · Reduced service | $64.57 | $64.57 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $24.55 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $16.22 | Facility | 56 · Pre-op care only | $12.88 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $61.66 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $16.22 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $251.19 Median $331.13 Typical High $426.58 | Professional | 25 · Same-day visit | $251.19 | $331.13 | $426.58 |
Where North Dakota sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$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.