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 $85.11 Median $89.13 Typical High $104.71 | Professional | None | $85.11 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $10.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $245.47 | Professional | None | $125.89 | $173.78 | $245.47 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $123.03 | Professional | 53 · Discontinued | $63.10 | $87.10 | $123.03 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $25.12 | $34.67 | $48.98 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.59 | $17.38 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $234.42 | Professional | None | $151.36 | $190.55 | $234.42 |
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 $537.03 | Professional | None | $107.15 | $208.93 | $537.03 |
United Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $208.93 | Professional | None | $91.20 | $173.78 | $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 $42.66 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $42.66 | $44.67 | $52.48 |
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
$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.