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 $87.10 Median $87.10 Typical High $120.23 | Facility | None | $87.10 | $87.10 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $18.20 | Facility | 55 · Aftercare only | $13.18 | $13.18 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $208.93 | Professional | None | $75.86 | $114.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $14.79 | $18.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $288.40 | Professional | None | $144.54 | $194.98 | $288.40 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $97.72 Typical High $144.54 | Professional | 53 · Discontinued | $72.44 | $97.72 | $144.54 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $57.54 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $309.03 | Professional | None | $123.03 | $199.53 | $309.03 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $263.03 | Facility | None | $87.10 | $120.23 | $263.03 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $741.31 | Professional | None | $117.49 | $218.78 | $741.31 |
United Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $239.88 | Professional | None | $89.13 | $141.25 | $239.88 |
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 $43.65 Median $43.65 Typical High $60.26 | Facility | 52 · Reduced service | $43.65 | $43.65 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.02 | Facility | 56 · Pre-op care only | $8.71 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $42.66 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.51 | $10.00 | $12.02 |
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· 4th of 51
$170
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.