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 $109.65 Median $123.03 Typical High $724.44 | Facility | None | $109.65 | $123.03 | $724.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.20 | Facility | 55 · Aftercare only | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $245.47 | Professional | None | $95.50 | $114.82 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $18.20 |
BCBS North Dakota Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $467.74 | Facility | None | $269.15 | $354.81 | $467.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $316.23 | Professional | None | $199.53 | $263.03 | $316.23 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $316.23 | Professional | None | $120.23 | $223.87 | $316.23 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $186.21 Typical High $501.19 | Facility | None | $109.65 | $186.21 | $501.19 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $1,174.90 | Professional | None | $125.89 | $239.88 | $1,174.90 |
United Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $281.84 | Professional | None | $95.50 | $190.55 | $281.84 |
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 $54.95 Median $54.95 Typical High $61.66 | Facility | 52 · Reduced service | $54.95 | $54.95 | $61.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.30 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $47.86 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $12.30 |
Where North Dakota sits
The same service costs 2.7 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· 3rd of 51
$224
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.