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 $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | None | $7.08 | $7.24 | $7.24 |
BCBS North Dakota Setting Professional Modifier None Typical Low $8.51 Median $11.22 Typical High $11.48 | Professional | None | $8.51 | $11.22 | $11.48 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $10.00 Median $13.49 Typical High $13.80 | Professional | 22 · Increased work | $10.00 | $13.49 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $19.50 | Facility | None | $16.98 | $16.98 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $13.49 | Professional | None | $10.96 | $10.96 | $13.49 |
Medica Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $15.14 | Facility | None | $7.24 | $7.24 | $15.14 |
Medica Setting Professional Modifier None Typical Low $3.80 Median $4.27 Typical High $8.32 | Professional | None | $3.80 | $4.27 | $8.32 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $7.94 | Professional | None | $3.31 | $4.27 | $7.94 |
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 $1.07 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.07 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.71 | $0.72 | $0.72 |
Where North Dakota sits
The same service costs 2.7 times more in Hawaii 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
$9.55
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.