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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $43.65 | Professional | None | $34.67 | $37.15 | $43.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $58.88 | Professional | None | $43.65 | $57.54 | $58.88 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $52.48 Median $69.18 Typical High $70.79 | Professional | 22 · Increased work | $52.48 | $69.18 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $107.15 | Facility | None | $93.33 | $93.33 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | None | $60.26 | $60.26 | $74.13 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $77.62 | Facility | None | $37.15 | $37.15 | $77.62 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $51.29 | Professional | None | $20.42 | $21.88 | $51.29 |
United Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $40.74 | Professional | None | $16.98 | $21.88 | $40.74 |
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 $18.62 Median $18.62 Typical High $19.05 | Professional | 52 · Reduced service | $18.62 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 54 · Surgery only | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.80 |
Where North Dakota sits
The same service costs 2.6 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· 11th of 51
$48.98
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.