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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $141.25 | Professional | None | $75.86 | $75.86 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $12.02 |
BCBS North Dakota Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
BCBS North Dakota Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $85.11 | Professional | None | $61.66 | $72.44 | $85.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $74.13 Median $87.10 Typical High $102.33 | Professional | 22 · Increased work | $74.13 | $87.10 | $102.33 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $16.98 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $97.72 | Professional | None | $75.86 | $77.62 | $97.72 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $74.13 Typical High $125.89 | Facility | None | $69.18 | $74.13 | $125.89 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $93.33 | Professional | None | $74.13 | $83.18 | $93.33 |
United Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $93.33 | Professional | None | $75.86 | $79.43 | $93.33 |
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 $38.02 Median $38.02 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 54 · Surgery only | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.94 |
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
$77.62
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.