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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | None | $89.13 | $89.13 | $93.33 |
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 $114.82 Median $114.82 Typical High $131.83 | Facility | None | $114.82 | $114.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $93.33 | Professional | None | $72.44 | $91.20 | $93.33 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $144.54 | Facility | None | $83.18 | $83.18 | $144.54 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $93.33 | Professional | None | $72.44 | $83.18 | $93.33 |
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 $44.67 Median $44.67 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $9.33 |
Where North Dakota sits
The same service costs 17.4 times more in Wyoming than in Montana. 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
$138
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.