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 $66.07 Median $138.04 Typical High $144.54 | Facility | None | $66.07 | $138.04 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $109.65 | Facility | 54 · Surgery only | $48.98 | $48.98 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $144.54 | Professional | None | $57.54 | $95.50 | $144.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $323.59 | Professional | None | $102.33 | $158.49 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $123.03 Median $190.55 Typical High $389.05 | Professional | 22 · Increased work | $123.03 | $190.55 | $389.05 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $112.20 Typical High $223.87 | Professional | 54 · Surgery only | $72.44 | $112.20 | $223.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $275.42 | Facility | None | $239.88 | $239.88 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $380.19 | Professional | None | $100.00 | $204.17 | $380.19 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $263.03 | Facility | None | $66.07 | $144.54 | $263.03 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $524.81 | Professional | None | $147.91 | $269.15 | $524.81 |
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 $67.61 Median $134.90 Typical High $288.40 | Professional | None | $67.61 | $134.90 | $288.40 |
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 $32.36 Median $32.36 Typical High $72.44 | Facility | 52 · Reduced service | $32.36 | $32.36 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $28.84 | Facility | 53 · Discontinued | $13.18 | $13.18 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $21.88 | Facility | 55 · Aftercare only | $9.77 | $9.77 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $14.45 | Facility | 56 · Pre-op care only | $6.61 | $6.61 | $14.45 |
Where North Dakota sits
The same service costs 3.1 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· 12th of 51
$148
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.