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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $5.13 | Professional | None | $4.07 | $4.07 | $5.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $22.39 Median $30.20 Typical High $30.90 | Professional | None | $22.39 | $30.20 | $30.90 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $26.92 Median $36.31 Typical High $37.15 | Professional | 22 · Increased work | $26.92 | $36.31 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $56.23 | Facility | None | $48.98 | $48.98 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $38.90 | Professional | None | $30.90 | $31.62 | $38.90 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $12.30 | Facility | None | $4.07 | $4.07 | $12.30 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $12.02 Typical High $23.99 | Professional | None | $11.75 | $12.02 | $23.99 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $23.44 | Professional | None | $8.91 | $12.02 | $23.44 |
4 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 52 · Reduced service Typical Low $2.04 Median $2.04 Typical High $2.57 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $1.02 | Professional | 53 · Discontinued | $0.81 | $0.81 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.78 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.52 |
Where North Dakota sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 4th of 51
$25.70
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.