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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $21.88 | Professional | None | $17.38 | $18.62 | $21.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $29.51 | Professional | None | $21.88 | $28.84 | $29.51 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $25.70 Median $34.67 Typical High $35.48 | Professional | 22 · Increased work | $25.70 | $34.67 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $53.70 | Facility | None | $46.77 | $46.77 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | None | $30.20 | $30.20 | $37.15 |
Medica Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $38.90 | Facility | None | $18.62 | $18.62 | $38.90 |
Medica Setting Professional Modifier None Typical Low $10.23 Median $10.96 Typical High $25.70 | Professional | None | $10.23 | $10.96 | $25.70 |
United Setting Professional Modifier None Typical Low $8.51 Median $10.96 Typical High $20.42 | Professional | None | $8.51 | $10.96 | $20.42 |
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 $9.33 Median $9.33 Typical High $9.55 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 54 · Surgery only | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.91 |
Where North Dakota sits
The same service costs 3.5 times more in Rhode Island 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· 10th of 51
$24.55
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.