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 $77.62 Median $77.62 Typical High $112.20 | Facility | None | $77.62 | $77.62 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $138.04 | Professional | None | $64.57 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.30 Typical High $16.60 | Professional | 55 · Aftercare only | $10.96 | $12.30 | $16.60 |
BCBS North Dakota Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $269.15 | Professional | None | $125.89 | $173.78 | $269.15 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $131.83 | Professional | 53 · Discontinued | $63.10 | $87.10 | $131.83 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $53.70 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $281.84 | Professional | None | $107.15 | $186.21 | $281.84 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $112.20 Typical High $229.09 | Facility | None | $77.62 | $112.20 | $229.09 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $691.83 | Professional | None | $104.71 | $213.80 | $691.83 |
United Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $218.78 | Professional | None | $79.43 | $128.82 | $218.78 |
3 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 $38.90 Median $38.90 Typical High $54.95 | Facility | 52 · Reduced service | $38.90 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.41 | $8.32 | $10.96 |
Where North Dakota sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 5th of 51
$151
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.