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 $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.91 Typical High $1.91 | Professional | None | $1.48 | $1.91 | $1.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $17.38 | Professional | None | $12.88 | $16.98 | $17.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $15.49 Median $20.42 Typical High $20.89 | Professional | 22 · Increased work | $15.49 | $20.42 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $4.07 | Facility | None | $3.55 | $3.55 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.29 Typical High $2.82 | Professional | None | $2.24 | $2.29 | $2.82 |
Medica Setting Facility Modifier None Typical Low $1.91 Median $1.91 Typical High $3.31 | Facility | None | $1.91 | $1.91 | $3.31 |
Medica Setting Professional Modifier None Typical Low $1.07 Median $1.29 Typical High $2.19 | Professional | None | $1.07 | $1.29 | $2.19 |
United Setting Professional Modifier None Typical Low $0.79 Median $1.29 Typical High $2.14 | Professional | None | $0.79 | $1.29 | $2.14 |
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 $0.22 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.22 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.15 | $0.19 | $0.19 |
Where North Dakota sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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· 9th of 51
$2.82
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.