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 $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $1.38 | Professional | None | $0.56 | $0.56 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
BCBS North Dakota Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $3.16 | Facility | None | $0.62 | $0.62 | $3.16 |
BCBS North Dakota Setting Professional Modifier None Typical Low $0.47 Median $0.54 Typical High $0.63 | Professional | None | $0.47 | $0.54 | $0.63 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $0.56 Median $0.65 Typical High $0.76 | Professional | 22 · Increased work | $0.56 | $0.65 | $0.76 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.11 Typical High $0.13 | Professional | 55 · Aftercare only | $0.09 | $0.11 | $0.13 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.56 Typical High $0.71 | Professional | None | $0.55 | $0.56 | $0.71 |
Medica Setting Facility Modifier None Typical Low $0.45 Median $0.54 Typical High $3.02 | Facility | None | $0.45 | $0.54 | $3.02 |
Medica Setting Professional Modifier None Typical Low $0.45 Median $0.50 Typical High $0.62 | Professional | None | $0.45 | $0.50 | $0.62 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.69 Typical High $0.81 | Professional | None | $0.65 | $0.69 | $0.81 |
1 more rate 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 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Where North Dakota sits
The same service costs 1.9 times more in Wyoming than in Oklahoma. 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· 45th of 51
$0.56
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.