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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $104.71 | Professional | None | $89.13 | $91.20 | $104.71 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $208.93 | Professional | None | $147.91 | $173.78 | $208.93 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $177.83 Median $208.93 Typical High $251.19 | Professional | 22 · Increased work | $177.83 | $208.93 | $251.19 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $102.33 | $123.03 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $177.83 Typical High $234.42 | Professional | None | $87.10 | $177.83 | $234.42 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $269.15 | Facility | None | $91.20 | $91.20 | $269.15 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $933.25 | Professional | None | $85.11 | $154.88 | $933.25 |
United Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $190.55 | Professional | None | $74.13 | $123.03 | $190.55 |
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 $44.67 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $44.67 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $17.78 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $10.47 |
Where North Dakota sits
The same service costs 3.1 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
$155
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.