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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
BCBS North Dakota Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $524.81 | Professional | None | $389.05 | $446.68 | $524.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $537.03 Typical High $630.96 | Professional | 22 · Increased work | $467.74 | $537.03 | $630.96 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $1,230.27 | Facility | None | $407.38 | $407.38 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $1,949.84 | Professional | None | $407.38 | $457.09 | $1,949.84 |
United Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $501.19 | Professional | None | $398.11 | $416.87 | $501.19 |
4 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 $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Where North Dakota sits
The same service costs 1.8 times more in Wyoming than in North Carolina. 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· 39th of 51
$479
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.