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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $6.03 Typical High $6.17 | Professional | None | $4.68 | $6.03 | $6.17 |
BCBS North Dakota Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $40.74 | Facility | None | $15.49 | $15.49 | $40.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $6.92 Median $9.33 Typical High $9.33 | Professional | None | $6.92 | $9.33 | $9.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $8.32 Median $10.96 Typical High $11.22 | Professional | 22 · Increased work | $8.32 | $10.96 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $16.98 | Facility | None | $14.79 | $14.79 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.55 Typical High $11.75 | Professional | None | $9.33 | $9.55 | $11.75 |
Medica Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $12.30 | Facility | None | $6.03 | $6.03 | $12.30 |
Medica Setting Professional Modifier None Typical Low $3.31 Median $3.47 Typical High $6.92 | Professional | None | $3.31 | $3.47 | $6.92 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.47 Typical High $6.61 | Professional | None | $2.75 | $3.47 | $6.61 |
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 $3.02 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.23 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $0.91 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.60 | $0.60 | $0.62 |
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· 9th of 51
$7.76
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.