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 $74.13 Median $74.13 Typical High $89.13 | Facility | None | $74.13 | $74.13 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $13.49 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $13.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.91 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $102.33 | Professional | None | $70.79 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $13.49 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $8.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $208.93 | Professional | None | $123.03 | $154.88 | $208.93 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.90 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $30.90 | $41.69 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.30 | $15.49 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $229.09 | Professional | None | $102.33 | $154.88 | $229.09 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $89.13 Typical High $223.87 | Facility | None | $74.13 | $89.13 | $223.87 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $549.54 | Professional | None | $83.18 | $173.78 | $549.54 |
United Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $173.78 | Professional | None | $74.13 | $112.20 | $173.78 |
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 $37.15 Median $37.15 Typical High $44.67 | Facility | 52 · Reduced service | $37.15 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $35.48 | $37.15 | $44.67 |
Where North Dakota sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 2nd of 51
$145
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.