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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | None | $123.03 | $123.03 | $128.82 |
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 $204.17 Median $204.17 Typical High $234.42 | Facility | None | $204.17 | $204.17 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | None | $131.83 | $131.83 | $162.18 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $218.78 | Facility | None | $125.89 | $125.89 | $218.78 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $141.25 | Professional | None | $125.89 | $128.82 | $141.25 |
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 $61.66 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.88 |
Where North Dakota sits
The same service costs 1.9 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
$162
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.