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 $0.43 Median $0.43 Typical High $10.96 | Facility | None | $0.43 | $0.43 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $0.19 Median $0.43 Typical High $0.46 | Professional | None | $0.19 | $0.43 | $0.46 |
BCBS North Dakota Setting Facility Modifier None Typical Low $4.07 Median $7.41 Typical High $234.42 | Facility | None | $4.07 | $7.41 | $234.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.48 Median $0.65 Typical High $0.65 | Professional | None | $0.48 | $0.65 | $0.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $0.58 Median $0.78 Typical High $0.78 | Professional | 22 · Increased work | $0.58 | $0.78 | $0.78 |
Cigna Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.35 | Facility | None | $1.17 | $1.17 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.93 | Professional | None | $0.76 | $0.76 | $0.93 |
Medica Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $5.75 | Facility | None | $0.43 | $0.43 | $5.75 |
Medica Setting Professional Modifier None Typical Low $0.24 Median $0.26 Typical High $0.51 | Professional | None | $0.24 | $0.26 | $0.51 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.26 Typical High $0.47 | Professional | None | $0.21 | $0.26 | $0.47 |
5 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 $0.22 Median $0.22 Typical High $0.23 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.17 | Professional | RR · Rental | $0.04 | $0.04 | $0.17 |
Where North Dakota sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 11th of 51
$0.54
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.