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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $10.72 Typical High $11.22 | Professional | None | $7.08 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.62 Typical High $1.66 | Professional | 55 · Aftercare only | $1.05 | $1.62 | $1.66 |
BCBS North Dakota Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $22.91 | Professional | None | $15.49 | $19.50 | $22.91 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $18.62 Median $23.44 Typical High $27.54 | Professional | 22 · Increased work | $18.62 | $23.44 | $27.54 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.89 Typical High $4.57 | Professional | 55 · Aftercare only | $3.09 | $3.89 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $14.13 | Professional | None | $9.77 | $9.77 | $14.13 |
Medica Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $32.36 | Facility | None | $10.72 | $10.72 | $32.36 |
Medica Setting Professional Modifier None Typical Low $5.89 Median $7.76 Typical High $74.13 | Professional | None | $5.89 | $7.76 | $74.13 |
United Setting Professional Modifier None Typical Low $4.57 Median $7.41 Typical High $11.75 | Professional | None | $4.57 | $7.41 | $11.75 |
3 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 $3.55 Median $5.37 Typical High $5.62 | Professional | 52 · Reduced service | $3.55 | $5.37 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $2.14 Typical High $2.24 | Professional | 53 · Discontinued | $1.41 | $2.14 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.07 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.71 | $1.07 | $1.12 |
Where North Dakota sits
The same service costs 46.8 times more in New York than in Arkansas. 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
$11.75
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.