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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $14.45 Typical High $14.45 | Professional | None | $11.48 | $14.45 | $14.45 |
BCBS North Dakota Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $22.39 | Professional | None | $16.60 | $21.88 | $22.39 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $19.95 Median $26.30 Typical High $26.92 | Professional | 22 · Increased work | $19.95 | $26.30 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $40.74 | Facility | None | $35.48 | $35.48 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $28.84 | Professional | None | $22.91 | $22.91 | $28.84 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $29.51 | Facility | None | $14.45 | $14.45 | $29.51 |
Medica Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $19.50 | Professional | None | $7.76 | $8.32 | $19.50 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.32 Typical High $15.85 | Professional | None | $6.61 | $8.32 | $15.85 |
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 $7.08 Median $7.08 Typical High $7.24 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 54 · Surgery only | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Where North Dakota sits
The same service costs 2.8 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· 9th of 51
$18.62
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.