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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | None | $229.09 | $229.09 | $288.40 |
BCBS North Dakota Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $251.19 | Facility | None | $245.47 | $245.47 | $251.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $251.19 | Professional | None | $186.21 | $213.80 | $251.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $223.87 Median $257.04 Typical High $302.00 | Professional | 22 · Increased work | $223.87 | $257.04 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $269.15 | Professional | None | $213.80 | $229.09 | $269.15 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $218.78 Typical High $371.54 | Facility | None | $204.17 | $218.78 | $371.54 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $954.99 | Professional | None | $218.78 | $239.88 | $954.99 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $275.42 | Professional | None | $223.87 | $234.42 | $275.42 |
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 $114.82 Median $114.82 Typical High $117.49 | Professional | 52 · Reduced service | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | 53 · Discontinued | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.44 |
Where North Dakota sits
Rates are fairly even across states for this service. 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
$229
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.