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 $89.13 Median $89.13 Typical High $120.23 | Facility | None | $89.13 | $89.13 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $17.78 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $208.93 | Professional | None | $77.62 | $117.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $17.78 |
BCBS North Dakota Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | None | $147.91 | $204.17 | $288.40 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $74.13 | $107.15 | $141.25 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $39.81 Typical High $57.54 | Professional | 55 · Aftercare only | $29.51 | $39.81 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $302.00 | Professional | None | $123.03 | $194.98 | $302.00 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $269.15 | Facility | None | $89.13 | $120.23 | $269.15 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $724.44 | Professional | None | $123.03 | $234.42 | $724.44 |
United Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $234.42 | Professional | None | $87.10 | $147.91 | $234.42 |
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 $44.67 Median $44.67 Typical High $60.26 | Facility | 52 · Reduced service | $44.67 | $44.67 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $12.02 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $9.12 | $12.02 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $204.17 Median $239.88 Typical High $302.00 | Professional | 25 · Same-day visit | $204.17 | $239.88 | $302.00 |
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
$178
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.