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 $16.22 Median $17.78 Typical High $18.62 | Facility | None | $16.22 | $17.78 | $18.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $13.80 | Facility | 54 · Surgery only | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $19.95 | Professional | None | $14.79 | $16.22 | $19.95 |
BCBS North Dakota Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $44.67 | Professional | None | $25.70 | $34.67 | $44.67 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $30.90 Median $41.69 Typical High $53.70 | Professional | 22 · Increased work | $30.90 | $41.69 | $53.70 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $24.55 Typical High $31.62 | Professional | 54 · Surgery only | $18.20 | $24.55 | $31.62 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.50 Median $26.30 Typical High $33.88 | Professional | 78 · Unplanned return to OR | $19.50 | $26.30 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $36.31 | Facility | None | $31.62 | $31.62 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $37.15 Typical High $50.12 | Professional | None | $26.30 | $37.15 | $50.12 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $28.84 Typical High $263.03 | Facility | None | $16.22 | $28.84 | $263.03 |
Medica Setting Professional Modifier None Typical Low $19.05 Median $35.48 Typical High $57.54 | Professional | None | $19.05 | $35.48 | $57.54 |
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 $16.98 Median $30.90 Typical High $37.15 | Professional | None | $16.98 | $30.90 | $37.15 |
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 $8.13 Median $8.13 Typical High $9.33 | Facility | 52 · Reduced service | $8.13 | $8.13 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.72 | Facility | 53 · Discontinued | $3.31 | $3.31 | $3.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.82 | Facility | 55 · Aftercare only | $2.45 | $2.45 | $2.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.86 | Facility | 56 · Pre-op care only | $1.62 | $1.62 | $1.86 |
Where North Dakota sits
The same service costs 3.9 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· 5th of 51
$32.36
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.