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 $245.47 Median $316.23 Typical High $316.23 | Facility | None | $245.47 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $234.42 | Facility | 54 · Surgery only | $181.97 | $181.97 | $234.42 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $169.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $316.23 | Professional | None | $213.80 | $251.19 | $316.23 |
BCBS North Dakota Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $3,981.07 | Facility | None | $575.44 | $2,187.76 | $3,981.07 |
BCBS North Dakota Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $812.83 | Professional | None | $457.09 | $588.84 | $812.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $549.54 Median $707.95 Typical High $977.24 | Professional | 22 · Increased work | $549.54 | $707.95 | $977.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $562.34 | Professional | 54 · Surgery only | $316.23 | $407.38 | $562.34 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $436.52 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $338.84 | $436.52 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Facility | None | $549.54 | $549.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $549.54 Typical High $2,137.96 | Facility | None | $245.47 | $549.54 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,819.70 | Professional | None | $323.59 | $575.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $616.60 | Professional | None | $257.04 | $457.09 | $616.60 |
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 $123.03 Median $123.03 Typical High $158.49 | Facility | 52 · Reduced service | $123.03 | $123.03 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $63.10 | Facility | 53 · Discontinued | $48.98 | $48.98 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $47.86 | Facility | 55 · Aftercare only | $36.31 | $36.31 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $31.62 | Facility | 56 · Pre-op care only | $24.55 | $24.55 | $31.62 |
Where North Dakota sits
The same service costs 4.8 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
$550
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.