How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $20.89 Median $22.39 Typical High $38.90 | Facility | None | $20.89 | $22.39 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.16 Median $3.39 Typical High $5.89 | Facility | 55 · Aftercare only | $3.16 | $3.39 | $5.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.24 Typical High $3.89 | Facility | 56 · Pre-op care only | $2.09 | $2.24 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $31.62 Typical High $38.90 | Professional | None | $20.89 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.89 Typical High $5.89 | Professional | 55 · Aftercare only | $3.16 | $3.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.57 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.09 | $2.57 | $3.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $91.20 | Professional | None | $34.67 | $56.23 | $91.20 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $41.69 Median $67.61 Typical High $109.65 | Professional | 22 · Increased work | $41.69 | $67.61 | $109.65 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $11.22 Typical High $18.20 | Professional | 55 · Aftercare only | $6.92 | $11.22 | $18.20 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.62 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.47 | $5.62 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $35.48 Typical High $54.95 | Professional | None | $21.88 | $35.48 | $54.95 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $38.90 Typical High $66.07 | Facility | None | $20.89 | $38.90 | $66.07 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $72.44 Typical High $245.47 | Professional | None | $35.48 | $72.44 | $245.47 |
United Setting Professional Modifier None Typical Low $21.38 Median $38.90 Typical High $75.86 | Professional | None | $21.38 | $38.90 | $75.86 |
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 Facility Modifier 52 · Reduced service Typical Low $10.47 Median $11.22 Typical High $19.50 | Facility | 52 · Reduced service | $10.47 | $11.22 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $12.88 Typical High $19.50 | Professional | 52 · Reduced service | $10.47 | $12.88 | $19.50 |
Where North Dakota sits
The same service costs 2.6 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· 10th of 51
$40.74
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.