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 $199.53 Median $309.03 Typical High $812.83 | Facility | None | $199.53 | $309.03 | $812.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $229.09 | Facility | 54 · Surgery only | $151.36 | $151.36 | $229.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $141.25 | $141.25 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $346.74 | Professional | None | $194.98 | $275.42 | $346.74 |
BCBS North Dakota Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $575.44 | Facility | None | $389.05 | $416.87 | $575.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $758.58 | Professional | None | $346.74 | $512.86 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $416.87 Median $616.60 Typical High $912.01 | Professional | 22 · Increased work | $416.87 | $616.60 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $239.88 | $354.81 | $537.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $257.04 | $380.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Facility | None | $549.54 | $549.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $870.96 | Professional | None | $331.13 | $537.03 | $870.96 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $524.81 | Facility | None | $134.90 | $263.03 | $524.81 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,479.11 | Professional | None | $316.23 | $562.34 | $1,479.11 |
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 $208.93 Median $380.19 Typical High $588.84 | Professional | None | $208.93 | $380.19 | $588.84 |
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 $100.00 Median $100.00 Typical High $154.88 | Facility | 52 · Reduced service | $100.00 | $100.00 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $61.66 | Facility | 53 · Discontinued | $39.81 | $39.81 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $45.71 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $30.90 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $30.90 |
Where North Dakota sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 9th of 51
$417
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.