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 $5.25 Median $5.25 Typical High $5.25 | Facility | None | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $12.88 | Professional | None | $5.25 | $5.25 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
BCBS North Dakota Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
BCBS North Dakota Setting Professional Modifier None Typical Low $4.27 Median $4.90 Typical High $5.89 | Professional | None | $4.27 | $4.90 | $5.89 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $5.13 Median $5.89 Typical High $7.08 | Professional | 22 · Increased work | $5.13 | $5.89 | $7.08 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.00 Typical High $1.17 | Professional | 55 · Aftercare only | $0.85 | $1.00 | $1.17 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $6.76 | Professional | None | $5.25 | $5.37 | $6.76 |
Medica Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $11.75 | Facility | None | $6.92 | $6.92 | $11.75 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $7.76 Typical High $8.71 | Professional | None | $6.92 | $7.76 | $8.71 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $6.17 | Professional | None | $4.90 | $5.25 | $6.17 |
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 $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where North Dakota sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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
$5.50
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.