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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | None | $31.62 | $31.62 | $32.36 |
BCBS North Dakota Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $50.12 | Professional | None | $37.15 | $48.98 | $50.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $44.67 Median $58.88 Typical High $60.26 | Professional | 22 · Increased work | $44.67 | $58.88 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $91.20 | Facility | None | $79.43 | $79.43 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | None | $51.29 | $51.29 | $63.10 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $66.07 | Facility | None | $31.62 | $31.62 | $66.07 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $43.65 | Professional | None | $17.38 | $18.62 | $43.65 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $34.67 | Professional | None | $14.45 | $18.62 | $34.67 |
5 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 $15.85 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 54 · Surgery only | $23.99 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.90 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.24 |
Where North Dakota sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 10th of 51
$41.69
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.