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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $23.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $512.86 | Professional | None | $331.13 | $436.52 | $512.86 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $102.33 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | None | $229.09 | $229.09 | $281.84 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $660.69 | Facility | None | $223.87 | $223.87 | $660.69 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $1,348.96 | Professional | None | $229.09 | $416.87 | $1,348.96 |
United Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $436.52 | Professional | None | $229.09 | $407.38 | $436.52 |
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 $109.65 Median $109.65 Typical High $117.49 | Professional | 52 · Reduced service | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | 53 · Discontinued | $44.67 | $44.67 | $46.77 |
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· 2nd of 51
$380
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.