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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $10.72 | Professional | None | $5.89 | $5.89 | $10.72 |
BCBS North Dakota Setting Professional Modifier None Typical Low $6.76 Median $9.12 Typical High $9.33 | Professional | None | $6.76 | $9.12 | $9.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $8.13 Median $10.96 Typical High $11.22 | Professional | 22 · Increased work | $8.13 | $10.96 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $16.98 | Facility | None | $14.79 | $14.79 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.55 Typical High $11.75 | Professional | None | $9.33 | $9.55 | $11.75 |
Medica Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $12.02 | Facility | None | $5.89 | $5.89 | $12.02 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $8.13 | Professional | None | $3.24 | $3.47 | $8.13 |
United Setting Professional Modifier None Typical Low $2.69 Median $3.47 Typical High $6.46 | Professional | None | $2.69 | $3.47 | $6.46 |
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 $2.95 Median $2.95 Typical High $3.02 | Professional | 52 · Reduced service | $2.95 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $1.20 | Professional | 53 · Discontinued | $1.17 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 54 · Surgery only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $0.89 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.60 |
Where North Dakota sits
The same service costs 3.2 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· 9th of 51
$7.76
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.