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 $21.38 Median $22.91 Typical High $22.91 | Facility | None | $21.38 | $22.91 | $22.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.24 Median $3.47 Typical High $3.47 | Facility | 55 · Aftercare only | $3.24 | $3.47 | $3.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.29 Typical High $2.29 | Facility | 56 · Pre-op care only | $2.14 | $2.29 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $22.91 | Professional | None | $21.38 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.39 Typical High $3.55 | Professional | 55 · Aftercare only | $3.24 | $3.39 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.24 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.14 | $2.24 | $2.34 |
BCBS North Dakota Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $39.81 | Professional | None | $24.55 | $30.20 | $39.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $29.51 Median $36.31 Typical High $47.86 | Professional | 22 · Increased work | $29.51 | $36.31 | $47.86 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $7.94 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $7.94 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.02 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.45 | $3.02 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $23.99 | Professional | None | $17.38 | $19.05 | $23.99 |
Medica Setting Facility Modifier None Typical Low $21.38 Median $22.91 Typical High $64.57 | Facility | None | $21.38 | $22.91 | $64.57 |
Medica Setting Professional Modifier None Typical Low $15.85 Median $30.90 Typical High $107.15 | Professional | None | $15.85 | $30.90 | $107.15 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $32.36 | Professional | None | $13.80 | $20.89 | $32.36 |
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 $10.72 Median $11.48 Typical High $11.48 | Facility | 52 · Reduced service | $10.72 | $11.48 | $11.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.27 Median $4.57 Typical High $4.57 | Facility | 53 · Discontinued | $4.27 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $11.22 Typical High $11.75 | Professional | 52 · Reduced service | $10.72 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.47 Typical High $4.79 | Professional | 53 · Discontinued | $4.27 | $4.47 | $4.79 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in New York. 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
$24.55
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.