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 $58.88 Median $154.88 Typical High $154.88 | Facility | None | $58.88 | $154.88 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $114.82 | Facility | 54 · Surgery only | $44.67 | $44.67 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $72.44 Typical High $154.88 | Professional | None | $53.70 | $72.44 | $154.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $346.74 Median $380.19 Typical High $1,659.59 | Facility | None | $346.74 | $380.19 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $371.54 | Professional | None | $93.33 | $147.91 | $371.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $112.20 Median $177.83 Typical High $436.52 | Professional | 22 · Increased work | $112.20 | $177.83 | $436.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $102.33 Typical High $257.04 | Professional | 54 · Surgery only | $64.57 | $102.33 | $257.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $109.65 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $69.18 | $109.65 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Facility | None | $269.15 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $416.87 | Professional | None | $91.20 | $181.97 | $416.87 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $177.83 Typical High $758.58 | Facility | None | $58.88 | $177.83 | $758.58 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $549.54 | Professional | None | $154.88 | $281.84 | $549.54 |
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 $61.66 Median $141.25 Typical High $302.00 | Professional | None | $61.66 | $141.25 | $302.00 |
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 Facility Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $77.62 | Facility | 52 · Reduced service | $29.51 | $29.51 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $22.91 | Facility | 55 · Aftercare only | $8.91 | $8.91 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $15.49 | Facility | 56 · Pre-op care only | $5.89 | $5.89 | $15.49 |
Where North Dakota sits
The same service costs 2.6 times more in Alaska 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· 20th of 51
$155
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.