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 $154.88 Median $204.17 Typical High $204.17 | Facility | None | $154.88 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $154.88 | Facility | 54 · Surgery only | $117.49 | $117.49 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $144.54 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $204.17 | Professional | None | $141.25 | $165.96 | $204.17 |
BCBS North Dakota Setting Facility Modifier None Typical Low $354.81 Median $2,238.72 Typical High $3,311.31 | Facility | None | $354.81 | $2,238.72 | $3,311.31 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $512.86 | Professional | None | $288.40 | $371.54 | $512.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $446.68 Typical High $602.56 | Professional | 22 · Increased work | $346.74 | $446.68 | $602.56 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $199.53 | $257.04 | $354.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Facility | None | $354.81 | $354.81 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $562.34 | Professional | None | $263.03 | $398.11 | $562.34 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $346.74 Typical High $1,698.24 | Facility | None | $154.88 | $346.74 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $1,174.90 | Professional | None | $208.93 | $371.54 | $1,174.90 |
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 $162.18 Median $295.12 Typical High $398.11 | Professional | None | $162.18 | $295.12 | $398.11 |
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 $77.62 Median $79.43 Typical High $102.33 | Facility | 52 · Reduced service | $77.62 | $79.43 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $40.74 | Facility | 53 · Discontinued | $30.90 | $31.62 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $30.90 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $20.42 | Facility | 56 · Pre-op care only | $15.49 | $15.85 | $20.42 |
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
$347
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.