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 $144.54 Median $190.55 Typical High $190.55 | Facility | None | $144.54 | $190.55 | $190.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $144.54 | Facility | 54 · Surgery only | $109.65 | $109.65 | $144.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | None | $134.90 | $158.49 | $194.98 |
BCBS North Dakota Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $1,148.15 | Facility | None | $501.19 | $933.25 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $467.74 | Professional | None | $263.03 | $338.84 | $467.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $316.23 Median $407.38 Typical High $562.34 | Professional | 22 · Increased work | $316.23 | $407.38 | $562.34 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $239.88 Typical High $331.13 | Professional | 54 · Surgery only | $186.21 | $239.88 | $331.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $257.04 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $199.53 | $257.04 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $389.05 | Facility | None | $338.84 | $338.84 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $524.81 | Professional | None | $263.03 | $371.54 | $524.81 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $275.42 Typical High $758.58 | Facility | None | $144.54 | $275.42 | $758.58 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $1,096.48 | Professional | None | $194.98 | $354.81 | $1,096.48 |
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 $147.91 Median $269.15 Typical High $371.54 | Professional | None | $147.91 | $269.15 | $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 $72.44 Median $74.13 Typical High $95.50 | Facility | 52 · Reduced service | $72.44 | $74.13 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $38.02 | Facility | 53 · Discontinued | $28.84 | $29.51 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $28.84 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $19.05 | Facility | 56 · Pre-op care only | $14.45 | $14.79 | $19.05 |
Where North Dakota sits
The same service costs 3.9 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
$324
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.