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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $13.18 Typical High $13.49 | Professional | None | $10.00 | $13.18 | $13.49 |
BCBS North Dakota Setting Professional Modifier None Typical Low $15.14 Median $20.42 Typical High $20.89 | Professional | None | $15.14 | $20.42 | $20.89 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $18.20 Median $24.55 Typical High $24.55 | Professional | 22 · Increased work | $18.20 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $38.02 | Facility | None | $33.11 | $33.11 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $26.30 | Professional | None | $20.89 | $21.38 | $26.30 |
Medica Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $26.92 | Facility | None | $13.18 | $13.18 | $26.92 |
Medica Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $15.14 | Professional | None | $7.24 | $7.59 | $15.14 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.59 Typical High $14.45 | Professional | None | $6.03 | $7.59 | $14.45 |
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 $6.61 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.69 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 54 · Surgery only | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.00 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.32 |
Where North Dakota sits
The same service costs 2.7 times more in Idaho 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
$17.38
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.