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 $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.20 | Facility | None | $1.17 | $1.17 | $1.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.89 Median $1.10 Typical High $1.29 | Professional | None | $0.89 | $1.10 | $1.29 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1.07 Median $1.32 Typical High $1.55 | Professional | 22 · Increased work | $1.07 | $1.32 | $1.55 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.22 Typical High $0.26 | Professional | 55 · Aftercare only | $0.18 | $0.22 | $0.26 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.41 | Professional | None | $1.10 | $1.12 | $1.41 |
Medica Setting Facility Modifier None Typical Low $1.41 Median $2.40 Typical High $8.71 | Facility | None | $1.41 | $2.40 | $8.71 |
Medica Setting Professional Modifier None Typical Low $1.26 Median $1.41 Typical High $1.58 | Professional | None | $1.26 | $1.41 | $1.58 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.15 | Professional | None | $1.02 | $1.02 | $1.15 |
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 $0.55 Median $0.55 Typical High $0.55 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where North Dakota sits
The same service costs 2.7 times more in Wyoming than in Alabama. 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· 13th of 51
$1.12
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.