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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $275.42 | Professional | None | $117.49 | $125.89 | $275.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $288.40 | Professional | None | $204.17 | $245.47 | $288.40 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $295.12 Typical High $346.74 | Professional | 22 · Increased work | $245.47 | $295.12 | $346.74 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $141.25 | $169.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $323.59 | Professional | None | $120.23 | $245.47 | $323.59 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $371.54 | Facility | None | $125.89 | $125.89 | $371.54 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $1,174.90 | Professional | None | $117.49 | $213.80 | $1,174.90 |
United Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $257.04 | Professional | None | $97.72 | $173.78 | $257.04 |
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 $61.66 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $14.79 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$214
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.