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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | None | $114.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $17.38 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $14.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $398.11 | Professional | None | $263.03 | $338.84 | $398.11 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $69.18 | $81.28 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $33.88 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $223.87 | Professional | None | $138.04 | $177.83 | $223.87 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $380.19 | Facility | None | $128.82 | $128.82 | $380.19 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $758.58 | Professional | None | $131.83 | $257.04 | $758.58 |
United Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $257.04 | Professional | None | $131.83 | $234.42 | $257.04 |
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 Professional Modifier 52 · Reduced service Typical Low $57.54 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $57.54 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.70 Typical High $28.18 | Professional | 53 · Discontinued | $22.91 | $25.70 | $28.18 |
Where North Dakota sits
The same service costs 2.6 times more in North Dakota than in Delaware. 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· 1st of 51
$263
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.