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 $25.70 Median $31.62 Typical High $33.88 | Facility | None | $25.70 | $31.62 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.05 Median $19.05 Typical High $25.70 | Facility | 54 · Surgery only | $19.05 | $19.05 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $25.70 Typical High $33.88 | Professional | None | $22.39 | $25.70 | $33.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $81.28 | Professional | None | $43.65 | $58.88 | $81.28 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $52.48 Median $70.79 Typical High $97.72 | Professional | 22 · Increased work | $52.48 | $70.79 | $97.72 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $41.69 Typical High $57.54 | Professional | 54 · Surgery only | $30.90 | $41.69 | $57.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $44.67 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $33.11 | $44.67 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $87.10 | Professional | None | $39.81 | $60.26 | $87.10 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $54.95 Typical High $263.03 | Facility | None | $25.70 | $54.95 | $263.03 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $64.57 Typical High $2,187.76 | Professional | None | $35.48 | $64.57 | $2,187.76 |
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 $26.92 Median $47.86 Typical High $69.18 | Professional | None | $26.92 | $47.86 | $69.18 |
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 $12.88 Median $12.88 Typical High $16.98 | Facility | 52 · Reduced service | $12.88 | $12.88 | $16.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.76 | Facility | 53 · Discontinued | $5.13 | $5.13 | $6.76 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $5.13 | Facility | 55 · Aftercare only | $3.80 | $3.80 | $5.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $3.39 | Facility | 56 · Pre-op care only | $2.57 | $2.57 | $3.39 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$53.70
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.