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 $0.40 Median $0.40 Typical High $0.40 | Facility | None | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
BCBS North Dakota Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $26.92 | Facility | None | $2.29 | $2.29 | $26.92 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.46 Median $0.62 Typical High $0.62 | Professional | None | $0.46 | $0.62 | $0.62 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $0.55 Median $0.72 Typical High $0.74 | Professional | 22 · Increased work | $0.55 | $0.72 | $0.74 |
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 $0.40 Median $0.40 Typical High $0.81 | Facility | None | $0.40 | $0.40 | $0.81 |
Medica Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.46 | Professional | None | $0.23 | $0.23 | $0.46 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.23 Typical High $0.45 | Professional | None | $0.18 | $0.23 | $0.45 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
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· 10th of 51
$0.52
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.