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 $93.33 Median $141.25 Typical High $144.54 | Facility | None | $93.33 | $141.25 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $109.65 | Facility | 54 · Surgery only | $69.18 | $69.18 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $144.54 | Professional | None | $83.18 | $123.03 | $144.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $354.81 | Professional | None | $158.49 | $234.42 | $354.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $190.55 Median $281.84 Typical High $426.58 | Professional | 22 · Increased work | $190.55 | $281.84 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $251.19 | Professional | 54 · Surgery only | $112.20 | $162.18 | $251.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $281.84 | Facility | None | $245.47 | $245.47 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $389.05 | Professional | None | $154.88 | $239.88 | $389.05 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $162.18 Typical High $660.69 | Facility | None | $93.33 | $162.18 | $660.69 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $676.08 | Professional | None | $151.36 | $269.15 | $676.08 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $281.84 | Professional | None | $97.72 | $173.78 | $281.84 |
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 $46.77 Median $46.77 Typical High $72.44 | Facility | 52 · Reduced service | $46.77 | $46.77 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $28.84 | Facility | 53 · Discontinued | $18.62 | $18.62 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $21.88 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $14.45 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $14.45 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$209
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.