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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.12 | Professional | None | $24.55 | $24.55 | $25.12 |
BCBS North Dakota Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $38.90 | Professional | None | $28.18 | $38.02 | $38.90 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $33.88 Median $45.71 Typical High $46.77 | Professional | 22 · Increased work | $33.88 | $45.71 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $70.79 | Facility | None | $61.66 | $61.66 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $48.98 | Professional | None | $38.90 | $39.81 | $48.98 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $50.12 | Facility | None | $24.55 | $24.55 | $50.12 |
Medica Setting Professional Modifier None Typical Low $13.49 Median $14.13 Typical High $33.88 | Professional | None | $13.49 | $14.13 | $33.88 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $26.92 | Professional | None | $11.22 | $14.13 | $26.92 |
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 $12.30 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.01 |
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 $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.51 |
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
$32.36
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.