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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $363.08 | Professional | None | $147.91 | $147.91 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
BCBS North Dakota Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $165.96 | Facility | None | $162.18 | $162.18 | $165.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $165.96 | Professional | None | $120.23 | $141.25 | $165.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $144.54 Median $165.96 Typical High $199.53 | Professional | 22 · Increased work | $144.54 | $165.96 | $199.53 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Facility | None | $107.15 | $107.15 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $190.55 | Professional | None | $147.91 | $151.36 | $190.55 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $134.90 Typical High $229.09 | Facility | None | $114.82 | $134.90 | $229.09 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $1,348.96 | Professional | None | $134.90 | $162.18 | $1,348.96 |
United Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $169.82 | Professional | None | $134.90 | $144.54 | $169.82 |
3 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 $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Where North Dakota sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 17th of 51
$151
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.