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 $5.25 Median $5.25 Typical High $5.25 | Facility | None | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.37 | Professional | None | $5.25 | $5.25 | $5.37 |
BCBS North Dakota Setting Professional Modifier None Typical Low $6.03 Median $8.13 Typical High $8.32 | Professional | None | $6.03 | $8.13 | $8.32 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $7.24 Median $9.77 Typical High $10.00 | Professional | 22 · Increased work | $7.24 | $9.77 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $14.79 | Facility | None | $12.88 | $12.88 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $10.23 | Professional | None | $8.32 | $8.32 | $10.23 |
Medica Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $10.72 | Facility | None | $5.25 | $5.25 | $10.72 |
Medica Setting Professional Modifier None Typical Low $2.88 Median $3.09 Typical High $7.24 | Professional | None | $2.88 | $3.09 | $7.24 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.09 Typical High $5.75 | Professional | None | $2.40 | $3.09 | $5.75 |
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 $2.63 Median $2.63 Typical High $2.69 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $1.07 | Professional | 53 · Discontinued | $1.05 | $1.05 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 54 · Surgery only | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where North Dakota sits
The same service costs 2.7 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· 10th of 51
$6.92
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.