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 $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier None Typical Low $0.21 Median $0.32 Typical High $0.32 | Professional | None | $0.21 | $0.32 | $0.32 |
BCBS North Dakota Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Facility | None | $0.71 | $0.71 | $0.71 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.44 Median $0.59 Typical High $0.60 | Professional | None | $0.44 | $0.59 | $0.60 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $0.52 Median $0.71 Typical High $0.72 | Professional | 22 · Increased work | $0.52 | $0.71 | $0.72 |
Cigna Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $0.68 | Facility | None | $0.59 | $0.59 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.47 | Professional | None | $0.38 | $0.38 | $0.47 |
Medica Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.79 | Facility | None | $0.32 | $0.32 | $0.79 |
Medica Setting Professional Modifier None Typical Low $0.22 Median $0.23 Typical High $0.45 | Professional | None | $0.22 | $0.23 | $0.45 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.23 Typical High $0.44 | Professional | None | $0.18 | $0.23 | $0.44 |
3 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 $0.04 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.04 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.15 |
Where North Dakota sits
The same service costs 2.5 times more in Montana 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· 3rd of 51
$0.44
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.