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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $407.38 | Professional | None | $323.59 | $331.13 | $407.38 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $501.19 | Facility | None | $190.55 | $295.12 | $501.19 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $1,258.93 | Professional | None | $309.03 | $346.74 | $1,258.93 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $389.05 | Professional | None | $309.03 | $331.13 | $389.05 |
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 $147.91 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $58.88 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $31.62 |
Where North Dakota sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 4th of 51
$331
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.