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 $123.03 Median $199.53 Typical High $199.53 | Facility | None | $123.03 | $199.53 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $147.91 | Facility | 54 · Surgery only | $91.20 | $91.20 | $147.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $138.04 | Facility | 78 · Unplanned return to OR | $85.11 | $85.11 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $199.53 | Professional | None | $114.82 | $123.03 | $199.53 |
BCBS North Dakota Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $478.63 | Professional | None | $218.78 | $316.23 | $478.63 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $263.03 Median $380.19 Typical High $575.44 | Professional | 22 · Increased work | $263.03 | $380.19 | $575.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $338.84 | Professional | 54 · Surgery only | $151.36 | $218.78 | $338.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $234.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $162.18 | $234.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Facility | None | $346.74 | $346.74 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $549.54 | Professional | None | $204.17 | $331.13 | $549.54 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $281.84 Typical High $758.58 | Facility | None | $123.03 | $281.84 | $758.58 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $912.01 | Professional | None | $204.17 | $363.08 | $912.01 |
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 $125.89 Median $234.42 Typical High $389.05 | Professional | None | $125.89 | $234.42 | $389.05 |
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 $61.66 Median $61.66 Typical High $100.00 | Facility | 52 · Reduced service | $61.66 | $61.66 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $39.81 | Facility | 53 · Discontinued | $24.55 | $24.55 | $39.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $30.20 | Facility | 55 · Aftercare only | $18.20 | $18.20 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $19.95 | Facility | 56 · Pre-op care only | $12.30 | $12.30 | $19.95 |
Where North Dakota sits
The same service costs 3.6 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
$295
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.