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 $28.18 Median $57.54 Typical High $57.54 | Facility | None | $28.18 | $57.54 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $42.66 | Facility | 54 · Surgery only | $21.38 | $21.38 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $58.88 | Professional | None | $25.12 | $38.02 | $58.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $144.54 | Professional | None | $48.98 | $72.44 | $144.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $58.88 Median $87.10 Typical High $173.78 | Professional | 22 · Increased work | $58.88 | $87.10 | $173.78 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $51.29 Typical High $100.00 | Professional | 54 · Surgery only | $33.88 | $51.29 | $100.00 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $54.95 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $36.31 | $54.95 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Facility | None | $102.33 | $102.33 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $162.18 | Professional | None | $43.65 | $87.10 | $162.18 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $57.54 Typical High $263.03 | Facility | None | $28.18 | $57.54 | $263.03 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $223.87 | Professional | None | $57.54 | $102.33 | $223.87 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $29.51 Median $57.54 Typical High $109.65 | Professional | None | $29.51 | $57.54 | $109.65 |
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 $14.13 Median $14.13 Typical High $28.18 | Facility | 52 · Reduced service | $14.13 | $14.13 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $11.48 | Facility | 53 · Discontinued | $5.75 | $5.75 | $11.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $8.51 | Facility | 55 · Aftercare only | $4.27 | $4.27 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $5.75 | Facility | 56 · Pre-op care only | $2.82 | $2.82 | $5.75 |
Where North Dakota sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 14th of 51
$64.57
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.