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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $18.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $275.42 | Professional | None | $186.21 | $239.88 | $275.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $223.87 Median $288.40 Typical High $331.13 | Professional | 22 · Increased work | $223.87 | $288.40 | $331.13 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Facility | None | $234.42 | $234.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $295.12 | Professional | None | $117.49 | $199.53 | $295.12 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $309.03 | Facility | None | $104.71 | $104.71 | $309.03 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $3,162.28 | Professional | None | $104.71 | $190.55 | $3,162.28 |
United Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $213.80 | Professional | None | $89.13 | $138.04 | $213.80 |
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 $52.48 Median $52.48 Typical High $61.66 | Professional | 52 · Reduced service | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $20.89 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.30 |
Where North Dakota sits
The same service costs 3.0 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· 4th of 51
$200
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.