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 $25.70 Median $38.90 Typical High $97.72 | Facility | None | $25.70 | $38.90 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $39.81 Typical High $70.79 | Professional | None | $25.70 | $39.81 | $70.79 |
BCBS North Dakota Setting Facility Modifier None Typical Low $48.98 Median $109.65 Typical High $416.87 | Facility | None | $48.98 | $109.65 | $416.87 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $58.88 | Professional | 53 · Discontinued | $25.70 | $38.02 | $58.88 |
BCBS North Dakota Setting Professional Modifier AF · Specialist physician Typical Low $51.29 Median $75.86 Typical High $117.49 | Professional | AF · Specialist physician | $51.29 | $75.86 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $138.04 | Professional | None | $45.71 | $95.50 | $138.04 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $45.71 Typical High $104.71 | Facility | None | $25.70 | $45.71 | $104.71 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $354.81 | Professional | None | $45.71 | $87.10 | $354.81 |
United Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $87.10 | Professional | None | $26.30 | $50.12 | $87.10 |
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 $12.59 Median $16.22 Typical High $22.39 | Facility | 52 · Reduced service | $12.59 | $16.22 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.80 Median $4.79 Typical High $6.76 | Facility | 55 · Aftercare only | $3.80 | $4.79 | $6.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.24 Typical High $4.57 | Facility | 56 · Pre-op care only | $2.51 | $3.24 | $4.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $20.42 Typical High $22.39 | Professional | 52 · Reduced service | $12.59 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.17 Typical High $6.76 | Professional | 55 · Aftercare only | $3.80 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.07 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.51 | $4.07 | $4.57 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $112.20 Typical High $144.54 | Professional | 25 · Same-day visit | $70.79 | $112.20 | $144.54 |
Where North Dakota sits
The same service costs 2.4 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
$50.12
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.