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 $407.38 Median $537.03 Typical High $537.03 | Facility | None | $407.38 | $537.03 | $537.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $407.38 | Facility | 54 · Surgery only | $309.03 | $309.03 | $407.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $53.70 | Facility | 56 · Pre-op care only | $40.74 | $41.69 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $288.40 | $288.40 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $537.03 | Professional | None | $389.05 | $436.52 | $537.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,288.25 | Professional | None | $707.95 | $933.25 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | 22 · Increased work | $851.14 | $1,096.48 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $501.19 | $645.65 | $891.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $93.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $70.79 | $93.33 | $128.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $537.03 | $691.83 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Facility | None | $933.25 | $933.25 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,479.11 | Professional | None | $691.83 | $1,000.00 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $831.76 | Facility | None | $125.89 | $407.38 | $831.76 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $5,011.87 | Professional | None | $549.54 | $1,047.13 | $5,011.87 |
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 $416.87 Median $794.33 Typical High $1,122.02 | Professional | None | $416.87 | $794.33 | $1,122.02 |
3 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 $204.17 Median $208.93 Typical High $269.15 | Facility | 52 · Reduced service | $204.17 | $208.93 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $109.65 | Facility | 53 · Discontinued | $81.28 | $83.18 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $81.28 | Facility | 55 · Aftercare only | $61.66 | $61.66 | $81.28 |
Where North Dakota sits
The same service costs 5.1 times more in Alaska than in Texas. 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
$851
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.