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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | None | $204.17 | $204.17 | $288.40 |
BCBS North Dakota Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $229.09 | Professional | None | $165.96 | $190.55 | $229.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $199.53 Median $229.09 Typical High $275.42 | Professional | 22 · Increased work | $199.53 | $229.09 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Facility | None | $234.42 | $234.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $263.03 | Professional | None | $204.17 | $208.93 | $263.03 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $199.53 Typical High $338.84 | Facility | None | $181.97 | $199.53 | $338.84 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $851.14 | Professional | None | $199.53 | $218.78 | $851.14 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $251.19 | Professional | None | $199.53 | $213.80 | $251.19 |
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 $102.33 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 53 · Discontinued | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $21.38 |
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· 16th of 51
$209
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.