How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | None | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $114.82 | Professional | None | $75.86 | $97.72 | $114.82 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $23.44 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.77 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $9.77 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | None | $54.95 | $54.95 | $69.18 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $165.96 | Facility | None | $54.95 | $54.95 | $165.96 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $331.13 | Professional | None | $57.54 | $102.33 | $331.13 |
United Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $109.65 | Professional | None | $57.54 | $100.00 | $109.65 |
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 Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.48 |
Where North Dakota sits
The same service costs 2.2 times more in Alaska than in Arizona. 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
$87.10
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.