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 $45.71 Median $72.44 Typical High $72.44 | Facility | None | $45.71 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $79.43 | Professional | None | $42.66 | $57.54 | $79.43 |
BCBS North Dakota Setting Facility Modifier None Typical Low $218.78 Median $239.88 Typical High $281.84 | Facility | None | $218.78 | $239.88 | $281.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $213.80 | Professional | None | $83.18 | $125.89 | $213.80 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $100.00 Median $151.36 Typical High $257.04 | Professional | 22 · Increased work | $100.00 | $151.36 | $257.04 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $87.10 Typical High $147.91 | Professional | 54 · Surgery only | $58.88 | $87.10 | $147.91 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $93.33 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $63.10 | $93.33 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Facility | None | $138.04 | $138.04 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $218.78 | Professional | None | $72.44 | $131.83 | $218.78 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $114.82 Typical High $263.03 | Facility | None | $45.71 | $114.82 | $263.03 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $338.84 | Professional | None | $75.86 | $128.82 | $338.84 |
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 $47.86 Median $85.11 Typical High $138.04 | Professional | None | $47.86 | $85.11 | $138.04 |
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 $22.91 Median $22.91 Typical High $36.31 | Facility | 52 · Reduced service | $22.91 | $22.91 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $14.79 | Facility | 53 · Discontinued | $9.12 | $9.12 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.96 | Facility | 55 · Aftercare only | $6.92 | $6.92 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $7.24 | Facility | 56 · Pre-op care only | $4.57 | $4.57 | $7.24 |
Where North Dakota sits
The same service costs 3.3 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· 6th of 51
$112
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.