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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $354.81 Typical High $354.81 | Professional | None | $131.83 | $354.81 | $354.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | None | $223.87 | $269.15 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | 22 · Increased work | $269.15 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Facility | None | $616.60 | $616.60 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $616.60 | Facility | None | $354.81 | $354.81 | $616.60 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | None | $478.63 | $478.63 | $537.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
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 $66.07 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $66.07 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $26.30 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $19.50 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $13.18 | $35.48 | $35.48 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska than in North Carolina. 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· 13th of 51
$295
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.