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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | None | $53.70 | $53.70 | $54.95 |
BCBS North Dakota Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $85.11 | Professional | None | $61.66 | $83.18 | $85.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $74.13 Median $100.00 Typical High $102.33 | Professional | 22 · Increased work | $74.13 | $100.00 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $154.88 | Facility | None | $134.90 | $134.90 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $107.15 | Professional | None | $85.11 | $87.10 | $107.15 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $109.65 | Facility | None | $53.70 | $53.70 | $109.65 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $74.13 | Professional | None | $29.51 | $31.62 | $74.13 |
United Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $58.88 | Professional | None | $24.55 | $31.62 | $58.88 |
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 $26.92 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $26.92 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 54 · Surgery only | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.50 |
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· 8th of 51
$70.79
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.