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 $89.13 Median $89.13 Typical High $104.71 | Facility | None | $89.13 | $89.13 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $15.49 | Facility | 55 · Aftercare only | $13.18 | $13.18 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.47 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $104.71 | Professional | None | $77.62 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.76 | $8.91 | $10.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $245.47 | Professional | None | $147.91 | $186.21 | $245.47 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $93.33 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $93.33 | $123.03 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $48.98 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.79 | $18.62 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $251.19 | Professional | None | $109.65 | $181.97 | $251.19 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $269.15 | Facility | None | $89.13 | $104.71 | $269.15 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $208.93 Typical High $724.44 | Professional | None | $107.15 | $208.93 | $724.44 |
United Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $208.93 | Professional | None | $83.18 | $134.90 | $208.93 |
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 $44.67 Median $44.67 Typical High $52.48 | Facility | 52 · Reduced service | $44.67 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $38.90 | $44.67 | $52.48 |
Where North Dakota sits
The same service costs 2.5 times more in Alaska than in Florida. 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· 4th of 51
$174
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.