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 $72.44 | Facility | None | $36.31 | $36.31 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $72.44 | Professional | None | $36.31 | $36.31 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $10.96 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $10.96 |
BCBS North Dakota Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
BCBS North Dakota Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $112.20 | Professional | None | $75.86 | $95.50 | $112.20 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $91.20 Median $114.82 Typical High $134.90 | Professional | 22 · Increased work | $91.20 | $114.82 | $134.90 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $114.82 | Facility | None | $64.57 | $64.57 | $114.82 |
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 $36.31 | Professional | 52 · Reduced service | $18.20 | $18.20 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $14.45 | Professional | 53 · Discontinued | $7.24 | $7.24 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $7.24 |
Where North Dakota sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 22nd of 51
$87.10
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.