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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | None | $48.98 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.94 |
BCBS North Dakota Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
BCBS North Dakota Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $53.70 | Professional | None | $38.90 | $44.67 | $53.70 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $46.77 Median $53.70 Typical High $64.57 | Professional | 22 · Increased work | $46.77 | $53.70 | $64.57 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.12 Typical High $10.72 | Professional | 55 · Aftercare only | $7.76 | $9.12 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $52.48 | Professional | None | $9.12 | $11.22 | $52.48 |
Medica Setting Facility Modifier None Typical Low $7.94 Median $48.98 Typical High $83.18 | Facility | None | $7.94 | $48.98 | $83.18 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $407.38 | Professional | None | $50.12 | $56.23 | $407.38 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | None | $50.12 | $52.48 | $63.10 |
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 $24.55 Median $24.55 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.25 |
Where North Dakota sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 38th of 51
$50.12
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.