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 $56.23 Median $56.23 Typical High $91.20 | Facility | None | $56.23 | $56.23 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $114.82 | Professional | None | $56.23 | $56.23 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $17.38 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $17.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $95.50 | Professional | None | $66.07 | $83.18 | $95.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $79.43 Median $100.00 Typical High $114.82 | Professional | 22 · Increased work | $79.43 | $100.00 | $114.82 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $16.60 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $97.72 | Facility | None | $56.23 | $56.23 | $97.72 |
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 $28.18 Median $28.18 Typical High $57.54 | Professional | 52 · Reduced service | $28.18 | $28.18 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $22.91 | Professional | 53 · Discontinued | $11.22 | $11.22 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $11.48 |
Where North Dakota sits
The same service costs 6.8 times more in North Carolina 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· 40th of 51
$75.86
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.