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 $25.12 Median $45.71 Typical High $79.43 | Facility | None | $25.12 | $45.71 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $33.88 | Facility | 54 · Surgery only | $18.62 | $18.62 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $36.31 Typical High $50.12 | Professional | None | $22.91 | $36.31 | $50.12 |
BCBS North Dakota Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $204.17 | Facility | None | $194.98 | $194.98 | $204.17 |
BCBS North Dakota Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $109.65 | Professional | None | $42.66 | $63.10 | $109.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $51.29 Median $75.86 Typical High $131.83 | Professional | 22 · Increased work | $51.29 | $75.86 | $131.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $44.67 Typical High $77.62 | Professional | 54 · Surgery only | $29.51 | $44.67 | $77.62 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $47.86 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $31.62 | $47.86 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $91.20 | Facility | None | $79.43 | $79.43 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $123.03 | Professional | None | $40.74 | $75.86 | $123.03 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $54.95 Typical High $263.03 | Facility | None | $25.12 | $54.95 | $263.03 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $85.11 Typical High $177.83 | Professional | None | $46.77 | $85.11 | $177.83 |
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 $25.70 Median $48.98 Typical High $89.13 | Professional | None | $25.70 | $48.98 | $89.13 |
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 $12.59 Median $12.59 Typical High $22.91 | Facility | 52 · Reduced service | $12.59 | $12.59 | $22.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $9.12 | Facility | 53 · Discontinued | $5.01 | $5.01 | $9.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $6.92 | Facility | 55 · Aftercare only | $3.80 | $3.80 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $4.57 | Facility | 56 · Pre-op care only | $2.51 | $2.51 | $4.57 |
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· 10th of 51
$57.54
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.