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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.01 | Professional | None | $3.89 | $3.89 | $5.01 |
BCBS North Dakota Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $6.17 | Professional | None | $4.57 | $6.03 | $6.17 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $5.50 Median $7.24 Typical High $7.41 | Professional | 22 · Increased work | $5.50 | $7.24 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $11.48 | Facility | None | $10.00 | $10.00 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.46 Typical High $7.94 | Professional | None | $6.31 | $6.46 | $7.94 |
Medica Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $8.13 | Facility | None | $3.89 | $3.89 | $8.13 |
Medica Setting Professional Modifier None Typical Low $2.14 Median $2.29 Typical High $5.37 | Professional | None | $2.14 | $2.29 | $5.37 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.29 Typical High $4.27 | Professional | None | $1.78 | $2.29 | $4.27 |
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 $1.95 Median $1.95 Typical High $2.00 | Professional | 52 · Reduced service | $1.95 | $1.95 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.79 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | 54 · Surgery only | $2.95 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.60 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.40 |
Where North Dakota sits
The same service costs 3.8 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· 10th of 51
$5.13
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.