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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $23.99 Typical High $31.62 | Professional | None | $17.38 | $23.99 | $31.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $38.02 | Professional | None | $28.18 | $37.15 | $38.02 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $33.88 Median $44.67 Typical High $45.71 | Professional | 22 · Increased work | $33.88 | $44.67 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Facility | None | $60.26 | $60.26 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $47.86 | Professional | None | $38.90 | $38.90 | $47.86 |
Medica Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $50.12 | Facility | None | $23.99 | $23.99 | $50.12 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $14.13 Typical High $27.54 | Professional | None | $13.18 | $14.13 | $27.54 |
United Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $26.30 | Professional | None | $10.96 | $14.13 | $26.30 |
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 $12.02 Median $12.02 Typical High $12.30 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.90 | Professional | 53 · Discontinued | $4.79 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | 54 · Surgery only | $18.20 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $2.45 |
Where North Dakota sits
The same service costs 2.6 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· 11th of 51
$31.62
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.