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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $18.62 | Professional | None | $14.13 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.34 Typical High $2.75 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
BCBS North Dakota Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $39.81 | Professional | None | $28.18 | $38.02 | $39.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $33.88 Median $44.67 Typical High $47.86 | Professional | 22 · Increased work | $33.88 | $44.67 | $47.86 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $5.62 | $7.59 | $7.94 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.80 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.82 | $3.80 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | None | $17.78 | $17.78 | $21.88 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $46.77 | Facility | None | $15.85 | $15.85 | $46.77 |
Medica Setting Professional Modifier None Typical Low $14.79 Median $26.30 Typical High $165.96 | Professional | None | $14.79 | $26.30 | $165.96 |
United Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $30.20 | Professional | None | $13.49 | $20.42 | $30.20 |
2 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 $7.76 Median $7.76 Typical High $9.12 | Professional | 52 · Reduced service | $7.76 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.63 | Professional | 53 · Discontinued | $3.16 | $3.16 | $3.63 |
Where North Dakota sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 6th of 51
$24.55
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.