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 $17.78 Median $30.20 Typical High $40.74 | Facility | None | $17.78 | $30.20 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $13.18 Median $13.18 Typical High $30.90 | Facility | 54 · Surgery only | $13.18 | $13.18 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $40.74 | Professional | None | $16.60 | $17.78 | $40.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $75.86 | Professional | None | $28.84 | $44.67 | $75.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $34.67 Median $53.70 Typical High $91.20 | Professional | 22 · Increased work | $34.67 | $53.70 | $91.20 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $30.90 Typical High $53.70 | Professional | 54 · Surgery only | $19.95 | $30.90 | $53.70 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $21.38 Median $36.31 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $21.38 | $36.31 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $60.26 | Facility | None | $52.48 | $52.48 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $83.18 | Professional | None | $29.51 | $50.12 | $83.18 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $42.66 Typical High $263.03 | Facility | None | $17.78 | $42.66 | $263.03 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $93.33 Typical High $144.54 | Professional | None | $41.69 | $93.33 | $144.54 |
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 $18.20 Median $41.69 Typical High $100.00 | Professional | None | $18.20 | $41.69 | $100.00 |
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 $8.91 Median $8.91 Typical High $20.42 | Facility | 52 · Reduced service | $8.91 | $8.91 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $8.32 | Facility | 53 · Discontinued | $3.55 | $3.55 | $8.32 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $6.17 | Facility | 55 · Aftercare only | $2.63 | $2.63 | $6.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $4.07 | Facility | 56 · Pre-op care only | $1.78 | $1.78 | $4.07 |
Where North Dakota sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 14th of 51
$43.65
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.