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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
BCBS North Dakota Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Facility | None | $67.61 | $67.61 | $69.18 |
BCBS North Dakota Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $69.18 | Professional | None | $51.29 | $58.88 | $69.18 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $61.66 Median $70.79 Typical High $83.18 | Professional | 22 · Increased work | $61.66 | $70.79 | $83.18 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $79.43 | Professional | None | $63.10 | $64.57 | $79.43 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $91.20 | Facility | None | $44.67 | $53.70 | $91.20 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $309.03 | Professional | None | $50.12 | $53.70 | $309.03 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | None | $57.54 | $57.54 | $64.57 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Where North Dakota sits
Rates are fairly even across states for this service. 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· 46th of 51
$61.66
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.