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 $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.16 | Professional | None | $3.09 | $3.09 | $3.16 |
BCBS North Dakota Setting Professional Modifier None Typical Low $3.55 Median $4.79 Typical High $4.79 | Professional | None | $3.55 | $4.79 | $4.79 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $4.27 Median $5.75 Typical High $5.75 | Professional | 22 · Increased work | $4.27 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.71 | Facility | None | $7.59 | $7.59 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.03 | Professional | None | $4.90 | $4.90 | $6.03 |
Medica Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $6.31 | Facility | None | $3.09 | $3.09 | $6.31 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $1.78 Typical High $4.27 | Professional | None | $1.70 | $1.78 | $4.27 |
United Setting Professional Modifier None Typical Low $1.41 Median $1.78 Typical High $3.39 | Professional | None | $1.41 | $1.78 | $3.39 |
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 $1.55 Median $1.55 Typical High $1.58 | Professional | 52 · Reduced service | $1.55 | $1.55 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.63 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.29 Median $2.29 Typical High $2.34 | Professional | 54 · Surgery only | $2.29 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.47 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.31 |
Where North Dakota sits
The same service costs 4.0 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
$4.07
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.