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 $97.72 Median $97.72 Typical High $131.83 | Facility | None | $97.72 | $97.72 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $19.95 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $162.18 | Professional | None | $83.18 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $19.95 |
BCBS North Dakota Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $316.23 | Professional | None | $162.18 | $223.87 | $316.23 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $158.49 | Professional | 53 · Discontinued | $81.28 | $109.65 | $158.49 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $44.67 Typical High $63.10 | Professional | 55 · Aftercare only | $33.11 | $44.67 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $331.13 | Professional | None | $138.04 | $218.78 | $331.13 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $131.83 Typical High $295.12 | Facility | None | $97.72 | $131.83 | $295.12 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $812.83 | Professional | None | $128.82 | $245.47 | $812.83 |
United Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $263.03 | Professional | None | $102.33 | $154.88 | $263.03 |
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 $48.98 Median $48.98 Typical High $66.07 | Facility | 52 · Reduced service | $48.98 | $48.98 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.18 | Facility | 56 · Pre-op care only | $9.77 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $48.98 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $13.18 |
Where North Dakota sits
The same service costs 2.7 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
$191
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.