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 $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.58 Typical High $1.58 | Professional | None | $1.41 | $1.58 | $1.58 |
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 $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | None | $147.91 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $2.82 | Facility | None | $1.58 | $1.58 | $2.82 |
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 $0.71 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.71 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.28 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.21 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.14 | $0.16 | $0.16 |
Where North Dakota sits
The same service costs 14.8 times more in North Dakota than in New Jersey. 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
$224
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.