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 $33.88 Median $33.88 Typical High $61.66 | Facility | None | $33.88 | $33.88 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | None | $33.88 | $33.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
BCBS North Dakota Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
BCBS North Dakota Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $38.02 | Professional | None | $27.54 | $31.62 | $38.02 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $33.11 Median $38.02 Typical High $45.71 | Professional | 22 · Increased work | $33.11 | $38.02 | $45.71 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.46 Typical High $7.59 | Professional | 55 · Aftercare only | $5.50 | $6.46 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $43.65 | Professional | None | $33.88 | $34.67 | $43.65 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $95.50 | Facility | None | $28.18 | $28.18 | $95.50 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $35.48 | Professional | None | $28.18 | $31.62 | $35.48 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | None | $28.18 | $30.20 | $35.48 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.39 |
Where North Dakota sits
The same service costs 5.4 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· 45th of 51
$33.88
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.