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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | None | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $19.05 |
BCBS North Dakota Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $117.49 | Professional | None | $85.11 | $97.72 | $117.49 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $102.33 Median $117.49 Typical High $141.25 | Professional | 22 · Increased work | $102.33 | $117.49 | $141.25 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $134.90 | Professional | None | $104.71 | $107.15 | $134.90 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $181.97 | Facility | None | $107.15 | $107.15 | $181.97 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $177.83 | Professional | None | $107.15 | $123.03 | $177.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $151.36 | Professional | None | $120.23 | $128.82 | $151.36 |
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 $52.48 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $20.89 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.59 |
Where North Dakota sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 20th of 51
$115
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.