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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | None | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $36.31 | $43.65 | $43.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $724.44 | Professional | None | $501.19 | $630.96 | $724.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $602.56 Median $758.58 Typical High $870.96 | Professional | 22 · Increased work | $602.56 | $758.58 | $870.96 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $100.00 | $125.89 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $512.86 | Facility | None | $295.12 | $295.12 | $512.86 |
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 $120.23 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $29.51 |
Where North Dakota sits
The same service costs 25.1 times more in North Dakota than in West Virginia. 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· 1st of 51
$562
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.