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 $117.49 | Facility | None | $87.10 | $87.10 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $17.38 | Facility | 55 · Aftercare only | $13.18 | $13.18 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $204.17 | Professional | None | $75.86 | $112.20 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $17.38 |
BCBS North Dakota Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Facility | None | $75.86 | $79.43 | $79.43 |
BCBS North Dakota Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $281.84 | Professional | None | $144.54 | $194.98 | $281.84 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $97.72 Typical High $141.25 | Professional | 53 · Discontinued | $72.44 | $97.72 | $141.25 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $56.23 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $295.12 | Professional | None | $120.23 | $190.55 | $295.12 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $117.49 Typical High $263.03 | Facility | None | $87.10 | $117.49 | $263.03 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $724.44 | Professional | None | $114.82 | $223.87 | $724.44 |
United Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $229.09 | Professional | None | $85.11 | $144.54 | $229.09 |
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 $43.65 Median $43.65 Typical High $58.88 | Facility | 52 · Reduced service | $43.65 | $43.65 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $11.75 | Facility | 56 · Pre-op care only | $8.71 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $42.66 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $11.75 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $199.53 Median $234.42 Typical High $309.03 | Professional | 25 · Same-day visit | $199.53 | $234.42 | $309.03 |
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
$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.