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 $8.13 Median $8.91 Typical High $8.91 | Facility | None | $8.13 | $8.91 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $10.23 | Professional | None | $8.13 | $8.91 | $10.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $29.51 | Professional | None | $17.78 | $22.39 | $29.51 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.47 Typical High $5.89 | Professional | 55 · Aftercare only | $3.55 | $4.47 | $5.89 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.24 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.78 | $2.24 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $16.98 | Professional | None | $12.30 | $15.49 | $16.98 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $8.91 Typical High $24.55 | Facility | None | $8.13 | $8.91 | $24.55 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $72.44 Typical High $79.43 | Professional | None | $16.98 | $72.44 | $79.43 |
United Setting Professional Modifier None Typical Low $12.02 Median $20.89 Typical High $25.70 | Professional | None | $12.02 | $20.89 | $25.70 |
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 $4.07 Median $4.47 Typical High $4.47 | Facility | 52 · Reduced service | $4.07 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.47 Typical High $5.13 | Professional | 52 · Reduced service | $4.07 | $4.47 | $5.13 |
Where North Dakota sits
The same service costs 6.3 times more in Alaska than in Arizona. 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· 4th of 51
$19.50
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.