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 $186.21 Median $186.21 Typical High $776.25 | Facility | None | $186.21 | $186.21 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $478.63 | Professional | None | $158.49 | $186.21 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $31.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $354.81 | Professional | None | $234.42 | $309.03 | $354.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $281.84 Median $371.54 Typical High $426.58 | Professional | 22 · Increased work | $281.84 | $371.54 | $426.58 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $46.77 | $63.10 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $380.19 | Professional | None | $165.96 | $309.03 | $380.19 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $562.34 | Facility | None | $186.21 | $186.21 | $562.34 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $1,174.90 | Professional | None | $177.83 | $288.40 | $1,174.90 |
United Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $371.54 | Professional | None | $162.18 | $229.09 | $371.54 |
3 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 $79.43 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $79.43 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $31.62 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $21.38 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 7th of 51
$288
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.