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 $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $93.33 | Professional | None | $63.10 | $74.13 | $93.33 |
BCBS North Dakota Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $181.97 | Professional | None | $120.23 | $147.91 | $181.97 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $74.13 | $91.20 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $29.51 | $36.31 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.02 | $14.79 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $190.55 | Professional | None | $104.71 | $147.91 | $190.55 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $223.87 | Facility | None | $74.13 | $74.13 | $223.87 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $457.09 | Professional | None | $67.61 | $138.04 | $457.09 |
United Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $158.49 | Professional | None | $60.26 | $93.33 | $158.49 |
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 $37.15 | Facility | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $32.36 | $37.15 | $37.15 |
Where North Dakota sits
The same service costs 3.0 times more in Alaska than in New York. 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
$138
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.