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 $30.20 Median $30.20 Typical High $30.90 | Facility | None | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | None | $30.20 | $30.20 | $30.90 |
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 $38.90 Median $38.90 Typical High $44.67 | Facility | None | $38.90 | $38.90 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $31.62 | Professional | None | $25.12 | $30.90 | $31.62 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $53.70 | Facility | None | $30.90 | $30.90 | $53.70 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $34.67 | Professional | None | $24.55 | $30.90 | $34.67 |
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 $14.79 Median $14.79 Typical High $15.49 | Professional | 52 · Reduced service | $14.79 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.09 |
Where North Dakota sits
The same service costs 4.2 times more in Wyoming than in Pennsylvania. 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· 16th of 51
$126
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.