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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | None | $97.72 | $97.72 | $102.33 |
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 $151.36 Median $151.36 Typical High $173.78 | Facility | None | $151.36 | $151.36 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $123.03 | Professional | None | $95.50 | $120.23 | $123.03 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $173.78 | Facility | None | $100.00 | $100.00 | $173.78 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | None | $93.33 | $100.00 | $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 $48.98 Median $48.98 Typical High $51.29 | Professional | 52 · Reduced service | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.23 |
Where North Dakota sits
The same service costs 2.5 times more in Wyoming 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· 4th of 51
$138
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.