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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | None | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $21.38 |
BCBS North Dakota Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
BCBS North Dakota Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $295.12 | Professional | None | $213.80 | $275.42 | $295.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $257.04 Median $331.13 Typical High $354.81 | Professional | 22 · Increased work | $257.04 | $331.13 | $354.81 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $54.95 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $346.74 | Professional | None | $194.98 | $275.42 | $346.74 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $389.05 | Facility | None | $131.83 | $131.83 | $389.05 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $776.25 | Professional | None | $120.23 | $229.09 | $776.25 |
United Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $257.04 | Professional | None | $112.20 | $218.78 | $257.04 |
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 $64.57 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $64.57 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $28.18 | Professional | 53 · Discontinued | $26.30 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $14.13 |
Where North Dakota sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 3rd of 51
$245
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.