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 $30.20 Median $54.95 Typical High $57.54 | Facility | None | $30.20 | $54.95 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $41.69 | Facility | 54 · Surgery only | $22.91 | $22.91 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $72.44 | Professional | None | $28.18 | $48.98 | $72.44 |
BCBS North Dakota Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $138.04 | Professional | None | $47.86 | $75.86 | $138.04 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $57.54 Median $91.20 Typical High $165.96 | Professional | 22 · Increased work | $57.54 | $91.20 | $165.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $53.70 Typical High $97.72 | Professional | 54 · Surgery only | $33.88 | $53.70 | $97.72 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $57.54 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $36.31 | $57.54 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Facility | None | $100.00 | $100.00 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $158.49 | Professional | None | $48.98 | $87.10 | $158.49 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $54.95 Typical High $263.03 | Facility | None | $30.20 | $54.95 | $263.03 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $223.87 | Professional | None | $56.23 | $112.20 | $223.87 |
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 $31.62 Median $61.66 Typical High $112.20 | Professional | None | $31.62 | $61.66 | $112.20 |
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 $15.14 Median $15.14 Typical High $27.54 | Facility | 52 · Reduced service | $15.14 | $15.14 | $27.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $10.96 | Facility | 53 · Discontinued | $6.03 | $6.03 | $10.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $8.32 | Facility | 55 · Aftercare only | $4.57 | $4.57 | $8.32 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $5.50 | Facility | 56 · Pre-op care only | $3.02 | $3.02 | $5.50 |
Where North Dakota sits
The same service costs 3.5 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· 11th of 51
$67.61
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.