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 $70.79 Median $70.79 Typical High $100.00 | Facility | None | $70.79 | $70.79 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $15.14 | Facility | 55 · Aftercare only | $10.47 | $10.47 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $177.83 | Professional | None | $61.66 | $91.20 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $15.14 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $15.14 |
BCBS North Dakota Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $199.53 | Facility | None | $58.88 | $58.88 | $199.53 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $239.88 | Professional | None | $117.49 | $158.49 | $239.88 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $79.43 Typical High $120.23 | Professional | 53 · Discontinued | $58.88 | $79.43 | $120.23 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $31.62 Typical High $47.86 | Professional | 55 · Aftercare only | $23.44 | $31.62 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $251.19 | Professional | None | $97.72 | $165.96 | $251.19 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $213.80 | Facility | None | $70.79 | $100.00 | $213.80 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $616.60 | Professional | None | $97.72 | $194.98 | $616.60 |
United Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $199.53 | Professional | None | $70.79 | $114.82 | $199.53 |
5 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 $35.48 Median $35.48 Typical High $50.12 | Facility | 52 · Reduced service | $35.48 | $35.48 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.00 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $38.90 Typical High $50.12 | Professional | 52 · Reduced service | $34.67 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.76 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.92 | $7.76 | $10.00 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | 25 · Same-day visit | $169.82 | $204.17 | $257.04 |
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· 3rd of 51
$138
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.