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 $0.71 Median $0.71 Typical High $0.71 | Facility | None | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
BCBS North Dakota Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.79 Median $1.07 Typical High $1.10 | Professional | None | $0.79 | $1.07 | $1.10 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $0.95 Median $1.29 Typical High $1.32 | Professional | 22 · Increased work | $0.95 | $1.29 | $1.32 |
Cigna Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $2.04 | Facility | None | $1.78 | $1.78 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.41 | Professional | None | $1.12 | $1.12 | $1.41 |
Medica Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $1.45 | Facility | None | $0.71 | $0.71 | $1.45 |
Medica Setting Professional Modifier None Typical Low $0.38 Median $0.41 Typical High $0.79 | Professional | None | $0.38 | $0.41 | $0.79 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.41 Typical High $0.76 | Professional | None | $0.32 | $0.41 | $0.76 |
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 $0.35 Median $0.35 Typical High $0.35 | Professional | 52 · Reduced service | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where North Dakota sits
The same service costs 2.6 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· 9th of 51
$0.91
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.