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 $123.03 Median $208.93 Typical High $208.93 | Facility | None | $123.03 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $724.44 | Professional | None | $123.03 | $208.93 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $31.62 Typical High $109.65 | Professional | 55 · Aftercare only | $18.62 | $31.62 | $109.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $457.09 | Professional | None | $229.09 | $331.13 | $457.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $275.42 Median $363.08 Typical High $549.54 | Professional | 22 · Increased work | $275.42 | $363.08 | $549.54 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $61.66 Typical High $93.33 | Professional | 55 · Aftercare only | $45.71 | $61.66 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $389.05 | Facility | None | $338.84 | $338.84 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $275.42 | Professional | None | $125.89 | $162.18 | $275.42 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $371.54 | Facility | None | $123.03 | $208.93 | $371.54 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $5,011.87 | Professional | None | $56.23 | $125.89 | $5,011.87 |
United Setting Professional Modifier None Typical Low $60.26 Median $204.17 Typical High $512.86 | Professional | None | $60.26 | $204.17 | $512.86 |
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 $61.66 Median $104.71 Typical High $363.08 | Professional | 52 · Reduced service | $61.66 | $104.71 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $41.69 Typical High $144.54 | Professional | 53 · Discontinued | $24.55 | $41.69 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $20.89 Typical High $72.44 | Professional | 56 · Pre-op care only | $12.30 | $20.89 | $72.44 |
Where North Dakota sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 16th of 51
$275
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.