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 $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | None | $12.30 | $12.30 | $12.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $19.50 | Professional | None | $14.13 | $19.05 | $19.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $16.98 Median $22.91 Typical High $23.44 | Professional | 22 · Increased work | $16.98 | $22.91 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $35.48 | Facility | None | $30.20 | $30.20 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | None | $19.50 | $19.50 | $24.55 |
Medica Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $25.12 | Facility | None | $12.30 | $12.30 | $25.12 |
Medica Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $16.98 | Professional | None | $6.76 | $7.08 | $16.98 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.08 Typical High $13.49 | Professional | None | $5.62 | $7.08 | $13.49 |
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 $6.17 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 54 · Surgery only | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.86 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.26 |
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
$16.22
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.