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 $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $8.51 Typical High $8.71 | Professional | None | $6.76 | $8.51 | $8.71 |
BCBS North Dakota Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $13.49 | Professional | None | $9.77 | $13.18 | $13.49 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $11.75 Median $15.85 Typical High $16.22 | Professional | 22 · Increased work | $11.75 | $15.85 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $24.55 | Facility | None | $21.38 | $21.38 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $16.98 | Professional | None | $13.49 | $13.49 | $16.98 |
Medica Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $17.38 | Facility | None | $8.51 | $8.51 | $17.38 |
Medica Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $11.75 | Professional | None | $4.68 | $4.90 | $11.75 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.90 Typical High $9.33 | Professional | None | $3.89 | $4.90 | $9.33 |
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 $4.27 Median $4.27 Typical High $4.37 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.74 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 54 · Surgery only | $6.31 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.26 Typical High $1.29 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Where North Dakota sits
The same service costs 2.9 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
$11.22
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.