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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $15.85 |
BCBS North Dakota Setting Professional Modifier None (both parts) Typical Low $123.03 Median $158.49 Typical High $190.55 | Professional | None (both parts) | $123.03 | $158.49 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $190.55 Typical High $223.87 | Professional | 22 · Increased work | $147.91 | $190.55 | $223.87 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $38.02 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $181.97 Typical High $229.09 | Professional | None (both parts) | $117.49 | $181.97 | $229.09 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $281.84 | Facility | None | $93.33 | $93.33 | $281.84 |
Medica Setting Professional Modifier None (both parts) Typical Low $95.50 Median $181.97 Typical High $537.03 | Professional | None (both parts) | $95.50 | $181.97 | $537.03 |
United Setting Professional Modifier None (both parts) Typical Low $95.50 Median $169.82 Typical High $199.53 | Professional | None (both parts) | $95.50 | $169.82 | $199.53 |
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 $42.66 Median $46.77 Typical High $53.70 | Professional | 52 · Reduced service | $42.66 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $21.38 | Professional | 53 · Discontinued | $16.98 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $10.72 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $177.83 Typical High $223.87 | Professional | TC · Technical part | $123.03 | $177.83 | $223.87 |
Where North Dakota sits
The same service costs 2.9 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· 6th of 51
$158
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.