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 $29.51 Median $60.26 Typical High $60.26 | Facility | None | $29.51 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $44.67 | Facility | 54 · Surgery only | $21.88 | $21.88 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $60.26 | Professional | None | $26.92 | $29.51 | $60.26 |
BCBS North Dakota Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $158.49 | Professional | None | $48.98 | $74.13 | $158.49 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $58.88 Median $89.13 Typical High $190.55 | Professional | 22 · Increased work | $58.88 | $89.13 | $190.55 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $51.29 Typical High $112.20 | Professional | 54 · Surgery only | $33.88 | $51.29 | $112.20 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $54.95 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $36.31 | $54.95 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $123.03 | Facility | None | $107.15 | $107.15 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $165.96 | Professional | None | $45.71 | $91.20 | $165.96 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $60.26 Typical High $263.03 | Facility | None | $29.51 | $60.26 | $263.03 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $1,230.27 | Professional | None | $61.66 | $114.82 | $1,230.27 |
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 $30.90 Median $58.88 Typical High $123.03 | Professional | None | $30.90 | $58.88 | $123.03 |
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 $14.79 Median $14.79 Typical High $30.20 | Facility | 52 · Reduced service | $14.79 | $14.79 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $12.02 | Facility | 53 · Discontinued | $5.89 | $5.89 | $12.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $8.91 | Facility | 55 · Aftercare only | $4.37 | $4.37 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $6.03 | Facility | 56 · Pre-op care only | $2.95 | $2.95 | $6.03 |
Where North Dakota sits
The same service costs 4.0 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· 13th 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.