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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $13.18 Typical High $15.85 | Professional | None | $11.22 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.00 Typical High $2.40 | Professional | 55 · Aftercare only | $1.70 | $2.00 | $2.40 |
BCBS North Dakota Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $34.67 | Professional | None | $28.84 | $34.67 | $34.67 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $34.67 Median $41.69 Typical High $41.69 | Professional | 22 · Increased work | $34.67 | $41.69 | $41.69 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $12.30 Typical High $38.02 | Professional | None | $10.00 | $12.30 | $38.02 |
Medica Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $39.81 | Facility | None | $13.18 | $13.18 | $39.81 |
Medica Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $1,905.46 | Professional | None | $11.22 | $13.49 | $1,905.46 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.79 Typical High $26.92 | Professional | None | $11.22 | $14.79 | $26.92 |
3 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 $5.62 Median $6.61 Typical High $7.94 | Professional | 52 · Reduced service | $5.62 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.63 Typical High $3.16 | Professional | 53 · Discontinued | $2.24 | $2.63 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.32 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.12 | $1.32 | $1.58 |
Where North Dakota sits
The same service costs 43.7 times more in Hawaii 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· 11th of 51
$19.95
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.