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 $34.67 Median $100.00 Typical High $102.33 | Facility | None | $34.67 | $100.00 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $25.70 Median $25.70 Typical High $75.86 | Facility | 54 · Surgery only | $25.70 | $25.70 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $58.88 Typical High $109.65 | Professional | None | $28.84 | $58.88 | $109.65 |
BCBS North Dakota Setting Facility Modifier None Typical Low $181.97 Median $489.78 Typical High $954.99 | Facility | None | $181.97 | $489.78 | $954.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $234.42 | Professional | None | $54.95 | $87.10 | $234.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $66.07 Median $104.71 Typical High $281.84 | Professional | 22 · Increased work | $66.07 | $104.71 | $281.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $61.66 Typical High $165.96 | Professional | 54 · Surgery only | $38.90 | $61.66 | $165.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $66.07 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $41.69 | $66.07 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $199.53 | Facility | None | $173.78 | $173.78 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $275.42 | Professional | None | $54.95 | $112.20 | $275.42 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $102.33 Typical High $263.03 | Facility | None | $34.67 | $102.33 | $263.03 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $380.19 | Professional | None | $102.33 | $177.83 | $380.19 |
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 $35.48 Median $70.79 Typical High $194.98 | Professional | None | $35.48 | $70.79 | $194.98 |
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 $17.38 Median $17.38 Typical High $50.12 | Facility | 52 · Reduced service | $17.38 | $17.38 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $20.42 | Facility | 53 · Discontinued | $6.92 | $6.92 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $15.14 | Facility | 55 · Aftercare only | $5.25 | $5.25 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $10.23 | Facility | 56 · Pre-op care only | $3.47 | $3.47 | $10.23 |
Where North Dakota sits
The same service costs 3.3 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· 13th of 51
$102
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.