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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $5.37 Typical High $5.37 | Professional | None | $4.17 | $5.37 | $5.37 |
BCBS North Dakota Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $10.96 Median $14.45 Typical High $14.79 | Professional | None | $10.96 | $14.45 | $14.79 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $13.18 Median $17.38 Typical High $17.78 | Professional | 22 · Increased work | $13.18 | $17.38 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $11.48 | Facility | None | $10.00 | $10.00 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.46 Typical High $7.94 | Professional | None | $6.31 | $6.46 | $7.94 |
Medica Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $16.22 | Facility | None | $5.37 | $5.37 | $16.22 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $3.72 Typical High $6.17 | Professional | None | $3.02 | $3.72 | $6.17 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.72 Typical High $6.17 | Professional | None | $2.24 | $3.72 | $6.17 |
2 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 55 · Aftercare only Typical Low $0.63 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.63 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.42 | $0.54 | $0.54 |
Where North Dakota sits
The same service costs 3.2 times more in Montana than in Colorado. 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· 2nd of 51
$7.94
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.