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 $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $9.77 | Facility | 55 · Aftercare only | $7.59 | $7.59 | $9.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.46 | Facility | 56 · Pre-op care only | $5.13 | $5.13 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $89.13 | Professional | None | $46.77 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $9.77 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.79 | $5.25 | $6.46 |
BCBS North Dakota Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $151.36 | Professional | None | $83.18 | $112.20 | $151.36 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $16.60 | $22.39 | $30.20 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.32 | $11.22 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $158.49 | Professional | None | $70.79 | $107.15 | $158.49 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $151.36 | Facility | None | $50.12 | $64.57 | $151.36 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $398.11 | Professional | None | $60.26 | $120.23 | $398.11 |
United Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $123.03 | Professional | None | $50.12 | $79.43 | $123.03 |
2 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 $25.12 Median $25.12 Typical High $32.36 | Facility | 52 · Reduced service | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $25.70 Typical High $32.36 | Professional | 52 · Reduced service | $23.99 | $25.70 | $32.36 |
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
$97.72
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.