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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.75 |
BCBS North Dakota Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $29.51 Median $33.88 Typical High $40.74 | Professional | None | $29.51 | $33.88 | $40.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $35.48 Median $40.74 Typical High $48.98 | Professional | 22 · Increased work | $35.48 | $40.74 | $48.98 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $5.89 | $6.76 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $42.66 | Facility | None | $37.15 | $37.15 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $46.77 | Professional | None | $36.31 | $37.15 | $46.77 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $63.10 | Facility | None | $37.15 | $37.15 | $63.10 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $165.96 | Professional | None | $37.15 | $41.69 | $165.96 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | None | $36.31 | $38.90 | $45.71 |
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 $18.20 Median $18.20 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.59 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.80 |
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· 19th of 51
$37.15
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.