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 $14.45 Median $33.11 Typical High $57.54 | Facility | None | $14.45 | $33.11 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $10.96 Median $10.96 Typical High $24.55 | Facility | 54 · Surgery only | $10.96 | $10.96 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $21.88 Typical High $33.88 | Professional | None | $13.18 | $21.88 | $33.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $79.43 | Professional | None | $25.12 | $38.02 | $79.43 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $30.20 Median $45.71 Typical High $95.50 | Professional | 22 · Increased work | $30.20 | $45.71 | $95.50 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $26.30 Typical High $56.23 | Professional | 54 · Surgery only | $17.78 | $26.30 | $56.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.05 Median $28.18 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $19.05 | $28.18 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $67.61 | Facility | None | $57.54 | $57.54 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $50.12 Typical High $91.20 | Professional | None | $24.55 | $50.12 | $91.20 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $43.65 Typical High $263.03 | Facility | None | $14.45 | $43.65 | $263.03 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $125.89 | Professional | None | $33.88 | $60.26 | $125.89 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $15.14 Median $29.51 Typical High $64.57 | Professional | None | $15.14 | $29.51 | $64.57 |
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 $7.24 Median $7.24 Typical High $16.60 | Facility | 52 · Reduced service | $7.24 | $7.24 | $16.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $6.61 | Facility | 53 · Discontinued | $2.95 | $2.95 | $6.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $4.90 | Facility | 55 · Aftercare only | $2.19 | $2.19 | $4.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $3.31 | Facility | 56 · Pre-op care only | $1.45 | $1.45 | $3.31 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 17th of 51
$34.67
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.