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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $10.47 Typical High $10.47 | Professional | None | $6.76 | $10.47 | $10.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $29.51 | Professional | None | $19.95 | $26.30 | $29.51 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $23.99 Median $31.62 Typical High $35.48 | Professional | 22 · Increased work | $23.99 | $31.62 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $12.30 Typical High $15.85 | Professional | None | $9.33 | $12.30 | $15.85 |
Medica Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $30.90 | Facility | None | $10.47 | $10.47 | $30.90 |
Medica Setting Professional Modifier None Typical Low $5.89 Median $7.08 Typical High $89.13 | Professional | None | $5.89 | $7.08 | $89.13 |
United Setting Professional Modifier None Typical Low $4.37 Median $7.08 Typical High $12.02 | Professional | None | $4.37 | $7.08 | $12.02 |
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 $1.02 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.02 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.68 | $1.05 | $1.05 |
Where North Dakota sits
The same service costs 95.5 times more in New York than in Kentucky. 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
$13.18
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.