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 $42.66 Median $83.18 Typical High $83.18 | Facility | None | $42.66 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $85.11 | Professional | None | $40.74 | $53.70 | $85.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $234.42 | Professional | None | $77.62 | $114.82 | $234.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $93.33 Median $138.04 Typical High $281.84 | Professional | 22 · Increased work | $93.33 | $138.04 | $281.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $81.28 Typical High $162.18 | Professional | 54 · Surgery only | $53.70 | $81.28 | $162.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $87.10 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $57.54 | $87.10 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $177.83 | Facility | None | $154.88 | $154.88 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $245.47 | Professional | None | $63.10 | $114.82 | $245.47 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $83.18 Typical High $263.03 | Facility | None | $42.66 | $83.18 | $263.03 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $338.84 | Professional | None | $85.11 | $162.18 | $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 $45.71 Median $87.10 Typical High $169.82 | Professional | None | $45.71 | $87.10 | $169.82 |
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 $21.38 Median $21.38 Typical High $41.69 | Facility | 52 · Reduced service | $21.38 | $21.38 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $16.60 | Facility | 53 · Discontinued | $8.71 | $8.71 | $16.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $12.59 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $8.32 | Facility | 56 · Pre-op care only | $4.27 | $4.27 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $26.92 Typical High $42.66 | Professional | 52 · Reduced service | $21.38 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.96 Typical High $16.98 | Professional | 53 · Discontinued | $8.51 | $10.96 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.13 Typical High $12.88 | Professional | 55 · Aftercare only | $6.31 | $8.13 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.37 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.27 | $5.37 | $8.51 |
Where North Dakota sits
The same service costs 3.9 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· 10th of 51
$102
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.