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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $75.86 | Professional | None | $26.30 | $26.30 | $75.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $41.69 | Professional | None | $30.90 | $40.74 | $41.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $37.15 Median $48.98 Typical High $50.12 | Professional | 22 · Increased work | $37.15 | $48.98 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $75.86 | Facility | None | $66.07 | $66.07 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | None | $42.66 | $42.66 | $52.48 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $54.95 | Facility | None | $26.30 | $26.30 | $54.95 |
Medica Setting Professional Modifier None Typical Low $14.45 Median $15.49 Typical High $30.20 | Professional | None | $14.45 | $15.49 | $30.20 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $28.84 | Professional | None | $12.02 | $15.49 | $28.84 |
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 $13.18 Median $13.18 Typical High $13.49 | Professional | 52 · Reduced service | $13.18 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 54 · Surgery only | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $2.69 |
Where North Dakota sits
The same service costs 3.1 times more in Rhode Island 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· 11th of 51
$34.67
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.