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 $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.71 Median $0.79 Typical High $0.81 | Professional | None | $0.71 | $0.79 | $0.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.91 Median $1.23 Typical High $1.26 | Professional | None | $0.91 | $1.23 | $1.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1.10 Median $1.48 Typical High $1.51 | Professional | 22 · Increased work | $1.10 | $1.48 | $1.51 |
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 $0.79 Median $0.79 Typical High $1.66 | Facility | None | $0.79 | $0.79 | $1.66 |
Medica Setting Professional Modifier None Typical Low $0.44 Median $0.46 Typical High $0.91 | Professional | None | $0.44 | $0.46 | $0.91 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.46 Typical High $0.87 | Professional | None | $0.36 | $0.46 | $0.87 |
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 $0.40 Median $0.40 Typical High $0.41 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
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
$1.05
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.