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 $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $1.02 | Professional | None | $0.81 | $0.81 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.15 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.15 |
BCBS North Dakota Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $72.44 | Professional | None | $50.12 | $63.10 | $72.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $60.26 Median $75.86 Typical High $87.10 | Professional | 22 · Increased work | $60.26 | $75.86 | $87.10 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $10.00 | $12.59 | $14.79 |
Medica Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.45 | Facility | None | $0.81 | $0.81 | $1.45 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $0.41 Median $0.41 Typical High $0.51 | Professional | 52 · Reduced service | $0.41 | $0.41 | $0.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.20 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.10 |
Where North Dakota sits
The same service costs 173.8 times more in Missouri than in Illinois. 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· 13th of 51
$56.23
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.