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 $56.23 Median $95.50 Typical High $95.50 | Facility | None | $56.23 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $70.79 | Facility | 54 · Surgery only | $41.69 | $41.69 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $95.50 | Professional | None | $53.70 | $79.43 | $95.50 |
BCBS North Dakota Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $234.42 | Professional | None | $95.50 | $144.54 | $234.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $114.82 Median $173.78 Typical High $281.84 | Professional | 22 · Increased work | $114.82 | $173.78 | $281.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $100.00 Typical High $165.96 | Professional | 54 · Surgery only | $67.61 | $100.00 | $165.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $107.15 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $72.44 | $107.15 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $186.21 | Facility | None | $162.18 | $162.18 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $257.04 | Professional | None | $89.13 | $158.49 | $257.04 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $125.89 Typical High $263.03 | Facility | None | $56.23 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $407.38 | Professional | None | $97.72 | $177.83 | $407.38 |
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 $57.54 Median $107.15 Typical High $186.21 | Professional | None | $57.54 | $107.15 | $186.21 |
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 $27.54 Median $27.54 Typical High $47.86 | Facility | 52 · Reduced service | $27.54 | $27.54 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $19.05 | Facility | 53 · Discontinued | $11.22 | $11.22 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $14.13 | Facility | 55 · Aftercare only | $8.32 | $8.32 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $9.55 | Facility | 56 · Pre-op care only | $5.62 | $5.62 | $9.55 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in New York. 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
$126
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.