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 $19.05 Median $19.05 Typical High $33.11 | Facility | None | $19.05 | $19.05 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $33.11 Typical High $66.07 | Professional | None | $19.05 | $33.11 | $66.07 |
BCBS North Dakota Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $75.86 | Professional | None | $30.90 | $45.71 | $75.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $37.15 Median $54.95 Typical High $91.20 | Professional | 22 · Increased work | $37.15 | $54.95 | $91.20 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $32.36 Typical High $53.70 | Professional | 54 · Surgery only | $21.38 | $32.36 | $53.70 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $34.67 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $22.91 | $34.67 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Facility | None | $54.95 | $54.95 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $47.86 Typical High $87.10 | Professional | None | $26.30 | $47.86 | $87.10 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $45.71 Typical High $263.03 | Facility | None | $19.05 | $45.71 | $263.03 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $162.18 | Professional | None | $33.88 | $60.26 | $162.18 |
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 $19.50 Median $36.31 Typical High $63.10 | Professional | None | $19.50 | $36.31 | $63.10 |
8 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 $9.55 Median $9.55 Typical High $16.60 | Facility | 52 · Reduced service | $9.55 | $9.55 | $16.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $6.61 | Facility | 53 · Discontinued | $3.80 | $3.80 | $6.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $5.01 | Facility | 55 · Aftercare only | $2.88 | $2.88 | $5.01 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $3.31 | Facility | 56 · Pre-op care only | $1.91 | $1.91 | $3.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $16.22 Typical High $18.20 | Professional | 52 · Reduced service | $9.55 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $6.46 Typical High $7.24 | Professional | 53 · Discontinued | $3.80 | $6.46 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $4.90 Typical High $5.50 | Professional | 55 · Aftercare only | $2.88 | $4.90 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.24 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.91 | $3.24 | $3.63 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 18th 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.