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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | None | $102.33 | $102.33 | $104.71 |
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 $162.18 Median $162.18 Typical High $186.21 | Facility | None | $162.18 | $162.18 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $128.82 | Professional | None | $104.71 | $125.89 | $128.82 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $177.83 | Facility | None | $100.00 | $100.00 | $177.83 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $112.20 | Professional | None | $100.00 | $102.33 | $112.20 |
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 $51.29 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.47 |
Where North Dakota sits
The same service costs 2.4 times more in Wyoming than in North Carolina. 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· 3rd 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.