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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | None | $70.79 | $70.79 | $74.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | None | $223.87 | $269.15 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | 22 · Increased work | $269.15 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Facility | None | $60.26 | $60.26 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $48.98 | Professional | None | $38.02 | $47.86 | $48.98 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $70.79 Typical High $123.03 | Facility | None | $33.11 | $70.79 | $123.03 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | None | $70.79 | $70.79 | $79.43 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
4 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 $35.48 Median $35.48 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.41 |
Where North Dakota sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 1st of 51
$141
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.