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 $275.42 Median $346.74 Typical High $346.74 | Facility | None | $275.42 | $346.74 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $257.04 | Facility | 54 · Surgery only | $208.93 | $208.93 | $257.04 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $194.98 | $194.98 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | None | $251.19 | $281.84 | $346.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $831.76 | Professional | None | $478.63 | $616.60 | $831.76 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $575.44 Median $741.31 Typical High $1,000.00 | Professional | 22 · Increased work | $575.44 | $741.31 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $426.58 Typical High $588.84 | Professional | 54 · Surgery only | $331.13 | $426.58 | $588.84 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $83.18 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $83.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $354.81 | $457.09 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $691.83 | Facility | None | $602.56 | $602.56 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $954.99 | Professional | None | $467.74 | $676.08 | $954.99 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $275.42 Typical High $588.84 | Facility | None | $125.89 | $275.42 | $588.84 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $2,089.30 | Professional | None | $354.81 | $645.65 | $2,089.30 |
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 $281.84 Median $524.81 Typical High $676.08 | Professional | None | $281.84 | $524.81 | $676.08 |
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 $138.04 Median $138.04 Typical High $169.82 | Facility | 52 · Reduced service | $138.04 | $138.04 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $69.18 | Facility | 53 · Discontinued | $54.95 | $54.95 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $51.29 | Facility | 55 · Aftercare only | $41.69 | $41.69 | $51.29 |
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· 7th of 51
$562
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.