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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | None | $19.95 | $19.95 | $20.89 |
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 $34.67 Median $34.67 Typical High $39.81 | Facility | None | $34.67 | $34.67 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $27.54 | Professional | None | $21.88 | $27.54 | $27.54 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $36.31 | Facility | None | $20.89 | $20.89 | $36.31 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $23.44 | Professional | None | $20.89 | $21.38 | $23.44 |
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 $10.00 Median $10.00 Typical High $10.47 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 53 · Discontinued | $3.98 | $3.98 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.09 |
Where North Dakota sits
The same service costs 6.3 times more in Massachusetts than in Indiana. 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
$126
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.