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 $2.29 Median $5.37 Typical High $5.50 | Professional | None | $2.29 | $5.37 | $5.50 |
BCBS North Dakota Setting Professional Modifier None Typical Low $6.31 Median $8.32 Typical High $8.51 | Professional | None | $6.31 | $8.32 | $8.51 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $7.59 Median $10.00 Typical High $10.23 | Professional | 22 · Increased work | $7.59 | $10.00 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $15.49 | Facility | None | $13.49 | $13.49 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.72 | Professional | None | $8.71 | $8.71 | $10.72 |
Medica Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $11.22 | Facility | None | $5.37 | $5.37 | $11.22 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $6.17 | Professional | None | $2.95 | $3.16 | $6.17 |
United Setting Professional Modifier None Typical Low $2.45 Median $3.16 Typical High $5.89 | Professional | None | $2.45 | $3.16 | $5.89 |
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 $0.81 Median $0.81 Typical High $0.83 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.55 |
Where North Dakota sits
The same service costs 2.5 times more in Idaho 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· 7th of 51
$7.08
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.