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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $26.92 | Professional | None | $19.95 | $26.30 | $26.92 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $23.99 Median $31.62 Typical High $32.36 | Professional | 22 · Increased work | $23.99 | $31.62 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Facility | None | $42.66 | $42.66 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | None | $27.54 | $27.54 | $33.88 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $35.48 | Facility | None | $17.38 | $17.38 | $35.48 |
Medica Setting Professional Modifier None Typical Low $9.33 Median $10.00 Typical High $23.44 | Professional | None | $9.33 | $10.00 | $23.44 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.00 Typical High $18.62 | Professional | None | $7.76 | $10.00 | $18.62 |
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 $8.51 Median $8.51 Typical High $8.71 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | 54 · Surgery only | $12.88 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
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
$22.39
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.