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 $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.56 Typical High $0.58 | Professional | None | $0.46 | $0.56 | $0.58 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.66 Median $0.87 Typical High $0.89 | Professional | None | $0.66 | $0.87 | $0.89 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $0.79 Median $1.07 Typical High $1.07 | Professional | 22 · Increased work | $0.79 | $1.07 | $1.07 |
Cigna Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.35 | Facility | None | $1.17 | $1.17 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.93 | Professional | None | $0.76 | $0.76 | $0.93 |
Medica Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $1.17 | Facility | None | $0.56 | $0.56 | $1.17 |
Medica Setting Professional Modifier None Typical Low $0.31 Median $0.33 Typical High $0.65 | Professional | None | $0.31 | $0.33 | $0.65 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.33 Typical High $0.62 | Professional | None | $0.26 | $0.33 | $0.62 |
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 $0.28 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where North Dakota sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 8th of 51
$0.76
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.