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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $380.19 | Professional | None | $251.19 | $323.59 | $380.19 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $77.62 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $25.12 | $32.36 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $218.78 | Professional | None | $173.78 | $177.83 | $218.78 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $549.54 | Facility | None | $181.97 | $181.97 | $549.54 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $1,096.48 | Professional | None | $186.21 | $338.84 | $1,096.48 |
United Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $363.08 | Professional | None | $186.21 | $331.13 | $363.08 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Where North Dakota sits
The same service costs 2.3 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
$288
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.