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 $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.94 | Professional | None | $7.76 | $7.76 | $7.94 |
BCBS North Dakota Setting Professional Modifier None Typical Low $9.12 Median $12.02 Typical High $12.30 | Professional | None | $9.12 | $12.02 | $12.30 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $10.96 Median $14.45 Typical High $14.79 | Professional | 22 · Increased work | $10.96 | $14.45 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $22.39 | Facility | None | $19.50 | $19.50 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.59 Typical High $15.49 | Professional | None | $12.30 | $12.59 | $15.49 |
Medica Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $16.22 | Facility | None | $7.76 | $7.76 | $16.22 |
Medica Setting Professional Modifier None Typical Low $4.27 Median $4.57 Typical High $8.91 | Professional | None | $4.27 | $4.57 | $8.91 |
United Setting Professional Modifier None Typical Low $3.55 Median $4.57 Typical High $8.51 | Professional | None | $3.55 | $4.57 | $8.51 |
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 $1.17 Median $1.17 Typical High $1.20 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.79 |
Where North Dakota sits
The same service costs 3.3 times more in Hawaii than in Utah. 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· 8th of 51
$10.23
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.