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 $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $1.78 Typical High $1.82 | Professional | None | $0.76 | $1.78 | $1.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $9.55 Median $9.77 Typical High $16.60 | Facility | None | $9.55 | $9.77 | $16.60 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2.04 Median $2.75 Typical High $2.82 | Professional | None | $2.04 | $2.75 | $2.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2.45 Median $3.31 Typical High $3.39 | Professional | 22 · Increased work | $2.45 | $3.31 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $5.37 | Facility | None | $4.68 | $4.68 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Professional | None | $3.02 | $3.02 | $3.72 |
Medica Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $3.72 | Facility | None | $1.78 | $1.78 | $3.72 |
Medica Setting Professional Modifier None Typical Low $0.98 Median $1.05 Typical High $2.04 | Professional | None | $0.98 | $1.05 | $2.04 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.05 Typical High $1.95 | Professional | None | $0.81 | $1.05 | $1.95 |
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 $0.89 Median $0.89 Typical High $0.91 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
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· 7th of 51
$2.34
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.