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 $177.83 Median $234.42 Typical High $234.42 | Facility | None | $177.83 | $234.42 | $234.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $177.83 | Facility | 54 · Surgery only | $131.83 | $134.90 | $177.83 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $125.89 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $123.03 | $125.89 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $263.03 | Professional | None | $158.49 | $194.98 | $263.03 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $588.84 | Professional | None | $331.13 | $426.58 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $512.86 Typical High $707.95 | Professional | 22 · Increased work | $398.11 | $512.86 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $302.00 Typical High $416.87 | Professional | 54 · Surgery only | $229.09 | $302.00 | $416.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $323.59 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $245.47 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Facility | None | $416.87 | $416.87 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $398.11 Typical High $1,698.24 | Facility | None | $177.83 | $398.11 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $1,348.96 | Professional | None | $239.88 | $436.52 | $1,348.96 |
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 $186.21 Median $338.84 Typical High $467.74 | Professional | None | $186.21 | $338.84 | $467.74 |
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 $89.13 Median $89.13 Typical High $117.49 | Facility | 52 · Reduced service | $89.13 | $89.13 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $46.77 | Facility | 53 · Discontinued | $35.48 | $35.48 | $46.77 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $35.48 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $23.44 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $23.44 |
Where North Dakota sits
The same service costs 4.7 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· 6th of 51
$398
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.