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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $13.49 | Professional | None | $9.77 | $11.48 | $13.49 |
BCBS North Dakota Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $30.20 | Professional | None | $23.44 | $29.51 | $30.20 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $28.18 Median $35.48 Typical High $36.31 | Professional | 22 · Increased work | $28.18 | $35.48 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $10.72 Typical High $33.11 | Professional | None | $8.51 | $10.72 | $33.11 |
Medica Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $33.88 | Facility | None | $11.48 | $11.48 | $33.88 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $281.84 | Professional | None | $9.77 | $11.75 | $281.84 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $23.44 | Professional | None | $9.77 | $12.59 | $23.44 |
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 $4.90 Median $5.62 Typical High $6.76 | Professional | 52 · Reduced service | $4.90 | $5.62 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.29 Typical High $2.69 | Professional | 53 · Discontinued | $1.95 | $2.29 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.70 Typical High $2.04 | Professional | 55 · Aftercare only | $1.45 | $1.70 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $1.12 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.98 | $1.12 | $1.35 |
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· 10th of 51
$15.14
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.