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 $147.91 Median $194.98 Typical High $1,995.26 | Facility | None | $147.91 | $194.98 | $1,995.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $112.20 Typical High $147.91 | Facility | 54 · Surgery only | $109.65 | $112.20 | $147.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $104.71 Typical High $138.04 | Facility | 78 · Unplanned return to OR | $102.33 | $104.71 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $199.53 | Professional | None | $128.82 | $154.88 | $199.53 |
BCBS North Dakota Setting Facility Modifier None Typical Low $363.08 Median $954.99 Typical High $2,511.89 | Facility | None | $363.08 | $954.99 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $489.78 | Professional | None | $269.15 | $354.81 | $489.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $323.59 Median $416.87 Typical High $588.84 | Professional | 22 · Increased work | $323.59 | $416.87 | $588.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $245.47 Typical High $338.84 | Professional | 54 · Surgery only | $190.55 | $245.47 | $338.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $263.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $204.17 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Facility | None | $346.74 | $346.74 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $537.03 | Professional | None | $251.19 | $371.54 | $537.03 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $331.13 Typical High $758.58 | Facility | None | $147.91 | $331.13 | $758.58 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $1,122.02 | Professional | None | $194.98 | $338.84 | $1,122.02 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $380.19 | Professional | None | $151.36 | $275.42 | $380.19 |
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 $74.13 Median $74.13 Typical High $97.72 | Facility | 52 · Reduced service | $74.13 | $74.13 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $38.90 | Facility | 53 · Discontinued | $29.51 | $29.51 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $29.51 | Facility | 55 · Aftercare only | $21.88 | $22.39 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $19.50 | Facility | 56 · Pre-op care only | $14.79 | $14.79 | $19.50 |
Where North Dakota sits
The same service costs 4.0 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· 5th of 51
$331
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.