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 $97.72 Median $181.97 Typical High $186.21 | Facility | None | $97.72 | $181.97 | $186.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $141.25 | Facility | 54 · Surgery only | $74.13 | $74.13 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $186.21 | Professional | None | $87.10 | $97.72 | $186.21 |
BCBS North Dakota Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $426.58 | Professional | None | $154.88 | $251.19 | $426.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $186.21 Median $295.12 Typical High $512.86 | Professional | 22 · Increased work | $186.21 | $295.12 | $512.86 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $173.78 Typical High $302.00 | Professional | 54 · Surgery only | $107.15 | $173.78 | $302.00 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $186.21 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $114.82 | $186.21 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Facility | None | $316.23 | $316.23 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $489.78 | Professional | None | $165.96 | $288.40 | $489.78 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $295.12 | Facility | None | $97.72 | $186.21 | $295.12 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $707.95 | Professional | None | $190.55 | $346.74 | $707.95 |
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 $102.33 Median $199.53 Typical High $371.54 | Professional | None | $102.33 | $199.53 | $371.54 |
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 $48.98 Median $48.98 Typical High $93.33 | Facility | 52 · Reduced service | $48.98 | $48.98 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $37.15 | Facility | 53 · Discontinued | $19.50 | $19.50 | $37.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $28.18 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $18.62 | Facility | 56 · Pre-op care only | $9.77 | $9.77 | $18.62 |
Where North Dakota sits
The same service costs 3.3 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· 11th of 51
$204
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.