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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | None | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.51 |
BCBS North Dakota Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $173.78 | Professional | None | $112.20 | $147.91 | $173.78 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $22.39 | $29.51 | $34.67 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | None | $81.28 | $81.28 | $102.33 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $234.42 | Facility | None | $77.62 | $77.62 | $234.42 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $467.74 | Professional | None | $79.43 | $144.54 | $467.74 |
United Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $154.88 | Professional | None | $79.43 | $141.25 | $154.88 |
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 $38.90 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $38.90 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $15.49 | $15.49 | $16.98 |
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
$129
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.