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 $72.44 Median $151.36 Typical High $154.88 | Facility | None | $72.44 | $151.36 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $117.49 | Facility | 54 · Surgery only | $54.95 | $54.95 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $154.88 | Professional | None | $64.57 | $91.20 | $154.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $1,479.11 | Facility | None | $478.63 | $478.63 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $354.81 | Professional | None | $114.82 | $186.21 | $354.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $138.04 Median $223.87 Typical High $426.58 | Professional | 22 · Increased work | $138.04 | $223.87 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $128.82 Typical High $251.19 | Professional | 54 · Surgery only | $81.28 | $128.82 | $251.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $138.04 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $87.10 | $138.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Facility | None | $263.03 | $263.03 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $416.87 | Professional | None | $117.49 | $234.42 | $416.87 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $154.88 Typical High $269.15 | Facility | None | $72.44 | $154.88 | $269.15 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $575.44 | Professional | None | $158.49 | $295.12 | $575.44 |
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 $74.13 Median $147.91 Typical High $316.23 | Professional | None | $74.13 | $147.91 | $316.23 |
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 $36.31 Median $36.31 Typical High $77.62 | Facility | 52 · Reduced service | $36.31 | $36.31 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $30.90 | Facility | 53 · Discontinued | $14.45 | $14.45 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $23.44 | Facility | 55 · Aftercare only | $10.96 | $10.96 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $15.49 | Facility | 56 · Pre-op care only | $7.24 | $7.24 | $15.49 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 15th of 51
$158
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.