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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $23.44 | Professional | None | $21.88 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.72 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.72 |
BCBS North Dakota Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $47.86 | Professional | None | $31.62 | $40.74 | $47.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $38.02 Median $48.98 Typical High $57.54 | Professional | 22 · Increased work | $38.02 | $48.98 | $57.54 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.13 Typical High $9.55 | Professional | 55 · Aftercare only | $6.31 | $8.13 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $58.88 | Professional | None | $30.90 | $46.77 | $58.88 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $66.07 | Facility | None | $22.39 | $22.39 | $66.07 |
Medica Setting Professional Modifier None Typical Low $22.91 Median $41.69 Typical High $275.42 | Professional | None | $22.91 | $41.69 | $275.42 |
United Setting Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $51.29 | Professional | None | $22.91 | $39.81 | $51.29 |
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 $10.96 Median $10.96 Typical High $12.30 | Professional | 52 · Reduced service | $10.96 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.47 Typical High $4.90 | Professional | 53 · Discontinued | $4.37 | $4.47 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $2.45 |
Where North Dakota sits
The same service costs 2.8 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
$39.81
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.