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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | None | $151.36 | $151.36 | $169.82 |
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 $251.19 Median $251.19 Typical High $288.40 | Facility | None | $251.19 | $251.19 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | None | $162.18 | $162.18 | $199.53 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $257.04 | Facility | None | $151.36 | $151.36 | $257.04 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $169.82 | Professional | None | $151.36 | $158.49 | $169.82 |
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 $75.86 Median $75.86 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 53 · Discontinued | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.85 |
Where North Dakota sits
The same service costs 2.9 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
$200
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.