How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $102.33 Median $213.80 Typical High $1,584.89 | Facility | None | $102.33 | $213.80 | $1,584.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $158.49 | Facility | 54 · Surgery only | $77.62 | $77.62 | $158.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $72.44 | $72.44 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $245.47 | Professional | None | $97.72 | $147.91 | $245.47 |
BCBS North Dakota Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $1,288.25 | Facility | None | $562.34 | $891.25 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $630.96 | Professional | None | $204.17 | $316.23 | $630.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $371.54 Typical High $758.58 | Professional | 22 · Increased work | $245.47 | $371.54 | $758.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $446.68 | Professional | 54 · Surgery only | $144.54 | $218.78 | $446.68 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $234.42 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $154.88 | $234.42 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $501.19 | Facility | None | $436.52 | $436.52 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $676.08 | Professional | None | $173.78 | $416.87 | $676.08 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $346.74 Typical High $758.58 | Facility | None | $102.33 | $346.74 | $758.58 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $954.99 | Professional | None | $213.80 | $354.81 | $954.99 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $371.54 | Professional | None | $107.15 | $204.17 | $371.54 |
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 Facility Modifier 52 · Reduced service Typical Low $51.29 Median $52.48 Typical High $107.15 | Facility | 52 · Reduced service | $51.29 | $52.48 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $42.66 | Facility | 53 · Discontinued | $20.42 | $20.89 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $31.62 | Facility | 55 · Aftercare only | $15.49 | $15.49 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $21.38 | Facility | 56 · Pre-op care only | $10.23 | $10.47 | $21.38 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 12th of 51
$275
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.