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 $74.13 Median $74.13 Typical High $77.62 | Facility | None | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $138.04 | Professional | None | $67.61 | $74.13 | $138.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | None | $117.49 | $141.25 | $165.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | 22 · Increased work | $141.25 | $169.82 | $199.53 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | 54 · Surgery only | $83.18 | $100.00 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $190.55 | Professional | None | $69.18 | $144.54 | $190.55 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $218.78 | Facility | None | $74.13 | $74.13 | $218.78 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $851.14 | Professional | None | $67.61 | $128.82 | $851.14 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
United Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $151.36 | Professional | None | $58.88 | $100.00 | $151.36 |
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 $36.31 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $12.88 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $8.51 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$123
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.