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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | None | $33.88 | $33.88 | $35.48 |
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 $53.70 Median $53.70 Typical High $61.66 | Facility | None | $53.70 | $53.70 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $43.65 | Professional | None | $34.67 | $43.65 | $43.65 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $58.88 | Facility | None | $33.88 | $33.88 | $58.88 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | None | $33.88 | $33.88 | $38.02 |
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 $16.98 Median $16.98 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.25 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.55 |
Where North Dakota sits
The same service costs 4.2 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.