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 $354.81 Median $478.63 Typical High $478.63 | Facility | None | $354.81 | $478.63 | $478.63 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $363.08 | Facility | 54 · Surgery only | $263.03 | $269.15 | $363.08 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $47.86 | Facility | 56 · Pre-op care only | $35.48 | $36.31 | $47.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $251.19 Typical High $338.84 | Facility | 78 · Unplanned return to OR | $245.47 | $251.19 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $478.63 | Professional | None | $338.84 | $371.54 | $478.63 |
BCBS North Dakota Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,148.15 | Professional | None | $630.96 | $831.76 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | 22 · Increased work | $758.58 | $1,000.00 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $794.33 | Professional | 54 · Surgery only | $446.68 | $575.44 | $794.33 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $83.18 Typical High $114.82 | Professional | 56 · Pre-op care only | $63.10 | $83.18 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $616.60 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $478.63 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Facility | None | $831.76 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $1,318.26 | Professional | None | $602.56 | $912.01 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $812.83 | Facility | None | $125.89 | $354.81 | $812.83 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $933.25 Typical High $2,691.53 | Professional | None | $489.78 | $933.25 | $2,691.53 |
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 $363.08 Median $691.83 Typical High $1,000.00 | Professional | None | $363.08 | $691.83 | $1,000.00 |
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 $177.83 Median $181.97 Typical High $239.88 | Facility | 52 · Reduced service | $177.83 | $181.97 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $95.50 | Facility | 53 · Discontinued | $70.79 | $72.44 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $72.44 | Facility | 55 · Aftercare only | $52.48 | $53.70 | $72.44 |
Where North Dakota sits
The same service costs 4.7 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
$741
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.