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 $81.28 Median $81.28 Typical High $114.82 | Facility | None | $81.28 | $81.28 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.38 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $204.17 | Professional | None | $70.79 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.45 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $14.45 | $17.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $275.42 | Professional | None | $134.90 | $186.21 | $275.42 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $91.20 Typical High $138.04 | Professional | 53 · Discontinued | $67.61 | $91.20 | $138.04 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $56.23 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $295.12 | Professional | None | $114.82 | $194.98 | $295.12 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $245.47 | Facility | None | $81.28 | $114.82 | $245.47 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $707.95 | Professional | None | $109.65 | $218.78 | $707.95 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $229.09 | Professional | None | $85.11 | $138.04 | $229.09 |
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 $40.74 Median $40.74 Typical High $57.54 | Facility | 52 · Reduced service | $40.74 | $40.74 | $57.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.48 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $48.98 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $11.48 |
Where North Dakota sits
The same service costs 2.8 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· 3rd of 51
$162
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.