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 $102.33 Median $158.49 Typical High $165.96 | Facility | None | $102.33 | $158.49 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $117.49 | Facility | 54 · Surgery only | $77.62 | $77.62 | $117.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $109.65 | Facility | 78 · Unplanned return to OR | $72.44 | $72.44 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $199.53 | Professional | None | $102.33 | $158.49 | $199.53 |
BCBS North Dakota Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $1,778.28 | Facility | None | $288.40 | $501.19 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $380.19 | Professional | None | $186.21 | $257.04 | $380.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | 22 · Increased work | $223.87 | $309.03 | $457.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $181.97 Typical High $269.15 | Professional | 54 · Surgery only | $131.83 | $181.97 | $269.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $141.25 | $194.98 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $323.59 | Facility | None | $281.84 | $281.84 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $446.68 | Professional | None | $169.82 | $275.42 | $446.68 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $309.03 | Facility | None | $102.33 | $177.83 | $309.03 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $794.33 | Professional | None | $162.18 | $288.40 | $794.33 |
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 $104.71 Median $213.80 Typical High $309.03 | Professional | None | $104.71 | $213.80 | $309.03 |
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 $51.29 Median $51.29 Typical High $79.43 | Facility | 52 · Reduced service | $51.29 | $51.29 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $31.62 | Facility | 53 · Discontinued | $20.42 | $20.89 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $23.99 | Facility | 55 · Aftercare only | $15.49 | $15.49 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $15.85 | Facility | 56 · Pre-op care only | $10.23 | $10.23 | $15.85 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 8th of 51
$240
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.