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 $38.90 Median $42.66 Typical High $43.65 | Facility | None | $38.90 | $42.66 | $43.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $6.61 | Facility | 55 · Aftercare only | $5.75 | $6.31 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.37 | Facility | 56 · Pre-op care only | $3.89 | $4.27 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $43.65 | Professional | None | $33.11 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $6.61 | Professional | 55 · Aftercare only | $5.75 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.89 | $4.17 | $4.37 |
BCBS North Dakota Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $74.13 | Professional | None | $43.65 | $56.23 | $74.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $52.48 Median $67.61 Typical High $89.13 | Professional | 22 · Increased work | $52.48 | $67.61 | $89.13 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $8.71 | $11.22 | $14.79 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.62 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.37 | $5.62 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $44.67 | Professional | None | $30.90 | $36.31 | $44.67 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $43.65 Typical High $114.82 | Facility | None | $38.90 | $43.65 | $114.82 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $58.88 Typical High $199.53 | Professional | None | $30.20 | $58.88 | $199.53 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $60.26 | Professional | None | $25.12 | $38.90 | $60.26 |
4 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 $19.05 Median $21.38 Typical High $21.88 | Facility | 52 · Reduced service | $19.05 | $21.38 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $8.71 | Facility | 53 · Discontinued | $7.76 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $20.89 Typical High $21.88 | Professional | 52 · Reduced service | $19.05 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $7.76 | $8.32 | $8.71 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 6th of 51
$44.67
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.