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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $190.55 | Professional | None | $123.03 | $162.18 | $190.55 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $38.02 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | None | $87.10 | $87.10 | $107.15 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $251.19 | Facility | None | $85.11 | $85.11 | $251.19 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $512.86 | Professional | None | $87.10 | $158.49 | $512.86 |
United Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $165.96 | Professional | None | $87.10 | $154.88 | $165.96 |
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 $42.66 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $16.98 | $16.98 | $17.78 |
Where North Dakota sits
The same service costs 2.2 times more in Alaska than in Kentucky. 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
$141
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.