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 $75.86 Median $154.88 Typical High $162.18 | Facility | None | $75.86 | $154.88 | $162.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $120.23 | Facility | 54 · Surgery only | $57.54 | $57.54 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $162.18 | Professional | None | $66.07 | $104.71 | $162.18 |
BCBS North Dakota Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Facility | None | $416.87 | $416.87 | $524.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $363.08 | Professional | None | $120.23 | $194.98 | $363.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $144.54 Median $234.42 Typical High $436.52 | Professional | 22 · Increased work | $144.54 | $234.42 | $436.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $134.90 Typical High $257.04 | Professional | 54 · Surgery only | $85.11 | $134.90 | $257.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $144.54 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $91.20 | $144.54 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Facility | None | $269.15 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $426.58 | Professional | None | $123.03 | $234.42 | $426.58 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $162.18 Typical High $269.15 | Facility | None | $75.86 | $162.18 | $269.15 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $588.84 | Professional | None | $162.18 | $302.00 | $588.84 |
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 $77.62 Median $154.88 Typical High $323.59 | Professional | None | $77.62 | $154.88 | $323.59 |
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 $38.02 Median $38.02 Typical High $79.43 | Facility | 52 · Reduced service | $38.02 | $38.02 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $32.36 | Facility | 53 · Discontinued | $15.14 | $15.14 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $23.99 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $16.22 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $16.22 |
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· 12th of 51
$162
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.