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 $309.03 Median $346.74 Typical High $446.68 | Facility | None | $309.03 | $346.74 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | None | $309.03 | $346.74 | $457.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,148.15 | Professional | None | $724.44 | $870.96 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $645.65 | Professional | None | $446.68 | $512.86 | $645.65 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $691.83 | Facility | None | $407.38 | $407.38 | $691.83 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $758.58 Typical High $2,754.23 | Professional | None | $407.38 | $758.58 | $2,754.23 |
United Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $812.83 | Professional | None | $302.00 | $524.81 | $812.83 |
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 Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $52.48 |
Where North Dakota sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 2nd of 51
$646
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.