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 $64.57 Median $134.90 Typical High $138.04 | Facility | None | $64.57 | $134.90 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $104.71 | Facility | 54 · Surgery only | $47.86 | $47.86 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $138.04 | Professional | None | $56.23 | $93.33 | $138.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $323.59 | Professional | None | $102.33 | $162.18 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $120.23 Median $194.98 Typical High $389.05 | Professional | 22 · Increased work | $120.23 | $194.98 | $389.05 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $114.82 Typical High $223.87 | Professional | 54 · Surgery only | $70.79 | $114.82 | $223.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $123.03 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $75.86 | $123.03 | $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 $107.15 Median $204.17 Typical High $371.54 | Professional | None | $107.15 | $204.17 | $371.54 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $138.04 Typical High $263.03 | Facility | None | $64.57 | $138.04 | $263.03 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $512.86 | Professional | None | $138.04 | $218.78 | $512.86 |
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 $66.07 Median $131.83 Typical High $218.78 | Professional | None | $66.07 | $131.83 | $218.78 |
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 $69.18 | Facility | 52 · Reduced service | $32.36 | $32.36 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $27.54 | Facility | 53 · Discontinued | $12.88 | $12.88 | $27.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $20.89 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $13.80 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $13.80 |
Where North Dakota sits
The same service costs 3.2 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· 11th of 51
$141
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.