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 $0.63 Median $0.63 Typical High $0.63 | Facility | None | $0.63 | $0.63 | $0.63 |
Aetna Setting Professional Modifier None Typical Low $0.49 Median $0.63 Typical High $0.63 | Professional | None | $0.49 | $0.63 | $0.63 |
BCBS North Dakota Setting Professional Modifier None Typical Low $3.39 Median $4.47 Typical High $4.57 | Professional | None | $3.39 | $4.47 | $4.57 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $4.07 Median $5.37 Typical High $5.50 | Professional | 22 · Increased work | $4.07 | $5.37 | $5.50 |
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 $0.93 Typical High $0.93 | Professional | None | $0.76 | $0.93 | $0.93 |
Medica Setting Facility Modifier None Typical Low $0.63 Median $0.63 Typical High $1.10 | Facility | None | $0.63 | $0.63 | $1.10 |
Medica Setting Professional Modifier None Typical Low $0.36 Median $0.43 Typical High $0.72 | Professional | None | $0.36 | $0.43 | $0.72 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.43 Typical High $0.72 | Professional | None | $0.27 | $0.43 | $0.72 |
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 $0.07 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Where North Dakota sits
The same service costs 190.5 times more in Wyoming 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· 16th of 51
$0.93
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.