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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $75.86 | Professional | None | $25.12 | $25.12 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
BCBS North Dakota Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
BCBS North Dakota Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $27.54 | Professional | None | $20.42 | $23.44 | $27.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $23.99 Median $28.18 Typical High $33.11 | Professional | 22 · Increased work | $23.99 | $28.18 | $33.11 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.68 Typical High $5.50 | Professional | 55 · Aftercare only | $4.07 | $4.68 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | None | $25.12 | $25.12 | $31.62 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $35.48 | Facility | None | $20.89 | $20.89 | $35.48 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $77.62 Typical High $87.10 | Professional | None | $20.89 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $83.18 | Professional | None | $16.60 | $17.78 | $83.18 |
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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where North Dakota sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 26th of 51
$25.12
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.