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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | None | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.89 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $4.68 Median $5.89 Typical High $6.92 | Professional | None | $4.68 | $5.89 | $6.92 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $5.62 Median $7.08 Typical High $8.13 | Professional | 22 · Increased work | $5.62 | $7.08 | $8.13 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $1.17 Typical High $1.38 | Professional | 55 · Aftercare only | $0.93 | $1.17 | $1.38 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.89 Typical High $7.24 | Professional | None | $5.50 | $5.89 | $7.24 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $9.77 | Facility | None | $5.75 | $5.75 | $9.77 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $25.12 | Professional | None | $5.75 | $6.31 | $25.12 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $7.08 | Professional | None | $5.75 | $6.03 | $7.08 |
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 $2.88 Median $2.88 Typical High $3.02 | Professional | 52 · Reduced service | $2.88 | $2.88 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $1.20 | Professional | 53 · Discontinued | $1.15 | $1.15 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.60 |
Where North Dakota sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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· 15th of 51
$5.89
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.