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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | None | $181.97 | $181.97 | $190.55 |
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 $288.40 Median $288.40 Typical High $331.13 | Facility | None | $288.40 | $288.40 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | None | $186.21 | $186.21 | $234.42 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $316.23 | Facility | None | $181.97 | $181.97 | $316.23 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | None | $181.97 | $181.97 | $204.17 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
5 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 $91.20 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $36.31 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 54 · Surgery only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $19.05 |
Where North Dakota sits
The same service costs 3.6 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
$234
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.