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 $229.09 Typical High $229.09 | Facility | None | $177.83 | $229.09 | $229.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $169.82 | Facility | 54 · Surgery only | $131.83 | $134.90 | $169.82 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $125.89 Typical High $158.49 | Facility | 78 · Unplanned return to OR | $123.03 | $125.89 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $229.09 | Professional | None | $162.18 | $186.21 | $229.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $562.34 | Professional | None | $316.23 | $407.38 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $380.19 Median $489.78 Typical High $676.08 | Professional | 22 · Increased work | $380.19 | $489.78 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $288.40 Typical High $389.05 | Professional | 54 · Surgery only | $223.87 | $288.40 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $309.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $239.88 | $309.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $457.09 | Facility | None | $398.11 | $398.11 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $630.96 | Professional | None | $302.00 | $446.68 | $630.96 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $758.58 | Facility | None | $177.83 | $323.59 | $758.58 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $1,348.96 | Professional | None | $229.09 | $416.87 | $1,348.96 |
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 $181.97 Median $331.13 Typical High $446.68 | Professional | None | $181.97 | $331.13 | $446.68 |
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 $112.20 | Facility | 52 · Reduced service | $89.13 | $89.13 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $45.71 | Facility | 53 · Discontinued | $35.48 | $35.48 | $45.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $33.88 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $22.91 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $22.91 |
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
$389
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.