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 $56.23 Median $56.23 Typical High $69.18 | Facility | None | $56.23 | $56.23 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.47 | Facility | 55 · Aftercare only | $8.51 | $8.51 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.92 | Facility | 56 · Pre-op care only | $5.62 | $5.62 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | None | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.47 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.92 |
BCBS North Dakota Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $165.96 | Professional | None | $79.43 | $109.65 | $165.96 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $39.81 | $54.95 | $83.18 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $33.11 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $33.11 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.96 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.94 | $10.96 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $154.88 | Professional | None | $95.50 | $123.03 | $154.88 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $169.82 | Facility | None | $56.23 | $69.18 | $169.82 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $346.74 | Professional | None | $70.79 | $141.25 | $346.74 |
United Setting Professional Modifier None Typical Low $57.54 Median $112.20 Typical High $141.25 | Professional | None | $57.54 | $112.20 | $141.25 |
2 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 $28.18 Median $28.18 Typical High $34.67 | Facility | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Where North Dakota sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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
$110
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.