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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $213.80 | Professional | None | $144.54 | $144.54 | $213.80 |
BCBS North Dakota Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $158.49 | Professional | None | $117.49 | $134.90 | $158.49 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $141.25 Median $162.18 Typical High $190.55 | Professional | 22 · Increased work | $141.25 | $162.18 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | None | $144.54 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $229.09 | Facility | None | $120.23 | $134.90 | $229.09 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $588.84 | Professional | None | $134.90 | $151.36 | $588.84 |
United Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | None | $138.04 | $144.54 | $169.82 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
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· 11th of 51
$148
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.