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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $186.21 | Professional | None | $60.26 | $60.26 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $11.48 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $11.48 |
BCBS North Dakota Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $66.07 | Facility | None | $64.57 | $64.57 | $66.07 |
BCBS North Dakota Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $66.07 | Professional | None | $48.98 | $56.23 | $66.07 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $58.88 Median $67.61 Typical High $79.43 | Professional | 22 · Increased work | $58.88 | $67.61 | $79.43 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $13.18 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $77.62 | Professional | None | $60.26 | $61.66 | $77.62 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $177.83 | Facility | None | $104.71 | $104.71 | $177.83 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $134.90 | Professional | None | $104.71 | $117.49 | $134.90 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $95.50 | Professional | None | $77.62 | $81.28 | $95.50 |
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 $30.20 Median $30.20 Typical High $38.02 | Professional | 52 · Reduced service | $30.20 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | 53 · Discontinued | $12.02 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $7.59 |
Where North Dakota sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 29th of 51
$64.57
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.