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 $31.62 Median $38.02 Typical High $46.77 | Facility | None | $31.62 | $38.02 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $46.77 | Professional | None | $31.62 | $38.90 | $46.77 |
BCBS North Dakota Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $131.83 | Professional | None | $67.61 | $91.20 | $131.83 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $64.57 | Professional | 53 · Discontinued | $33.88 | $45.71 | $64.57 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $26.30 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $26.30 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.12 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.76 | $9.12 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $151.36 | Professional | None | $100.00 | $120.23 | $151.36 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $46.77 Typical High $95.50 | Facility | None | $31.62 | $46.77 | $95.50 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $269.15 Typical High $323.59 | Professional | None | $63.10 | $269.15 | $323.59 |
United Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $91.20 | Professional | None | $40.74 | $60.26 | $91.20 |
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 $15.85 Median $19.50 Typical High $23.44 | Facility | 52 · Reduced service | $15.85 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $19.50 Typical High $23.44 | Professional | 52 · Reduced service | $15.85 | $19.50 | $23.44 |
Where North Dakota sits
The same service costs 2.6 times more in North Dakota than in Oklahoma. 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· 1st of 51
$77.62
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.