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 $4.90 Median $4.90 Typical High $19.50 | Facility | None | $4.90 | $4.90 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $8.32 | Professional | None | $4.90 | $4.90 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.78 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.78 |
BCBS North Dakota Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
BCBS North Dakota Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $11.75 | Professional | None | $7.59 | $8.71 | $11.75 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $9.12 Median $10.47 Typical High $14.13 | Professional | 22 · Increased work | $9.12 | $10.47 | $14.13 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.78 Typical High $2.34 | Professional | 55 · Aftercare only | $1.51 | $1.78 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $9.55 Typical High $12.02 | Professional | None | $7.76 | $9.55 | $12.02 |
Medica Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $45.71 | Facility | None | $4.90 | $4.90 | $45.71 |
Medica Setting Professional Modifier None Typical Low $7.24 Median $11.22 Typical High $29.51 | Professional | None | $7.24 | $11.22 | $29.51 |
United Setting Professional Modifier None Typical Low $5.01 Median $8.71 Typical High $11.22 | Professional | None | $5.01 | $8.71 | $11.22 |
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 $2.45 Median $2.45 Typical High $2.57 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $1.02 | Professional | 53 · Discontinued | $0.98 | $0.98 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.51 |
Where North Dakota sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 1st of 51
$8.71
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.