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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $83.18 | Professional | None | $60.26 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
BCBS Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $67.61 | Professional | None | $48.98 | $56.23 | $67.61 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $58.88 Median $67.61 Typical High $79.43 | Professional | 22 · Increased work | $58.88 | $67.61 | $79.43 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $13.49 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $77.62 | Professional | None | $60.26 | $61.66 | $77.62 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $54.95 Typical High $93.33 | Facility | None | $46.77 | $54.95 | $93.33 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $2,137.96 | Professional | None | $54.95 | $61.66 | $2,137.96 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $70.79 | Professional | None | $56.23 | $60.26 | $70.79 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where North Dakota sits
Rates are fairly even across states for this service. 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· 8th of 51
$61.66
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.