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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $44.67 | Professional | None | $43.65 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.76 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $120.23 | Professional | None | $77.62 | $102.33 | $120.23 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $15.49 | $20.42 | $23.99 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $10.23 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $67.61 | Professional | None | $53.70 | $54.95 | $67.61 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $131.83 | Facility | None | $43.65 | $43.65 | $131.83 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $288.40 | Professional | None | $44.67 | $85.11 | $288.40 |
United Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $91.20 | Professional | None | $44.67 | $81.28 | $91.20 |
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 $21.88 Median $21.88 Typical High $22.39 | Professional | 52 · Reduced service | $21.88 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.12 |
Where North Dakota sits
The same service costs 2.6 times more in North Dakota than in Ohio. 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
$89.13
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.