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 $43.65 Typical High $61.66 | Facility | None | $42.66 | $43.65 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $77.62 | Professional | None | $42.66 | $60.26 | $77.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $162.18 | Professional | None | $77.62 | $112.20 | $162.18 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $93.33 Median $134.90 Typical High $194.98 | Professional | 22 · Increased work | $93.33 | $134.90 | $194.98 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $77.62 Typical High $114.82 | Professional | 54 · Surgery only | $53.70 | $77.62 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $83.18 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $57.54 | $83.18 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $128.82 | Facility | None | $112.20 | $112.20 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $177.83 | Professional | None | $60.26 | $107.15 | $177.83 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $75.86 Typical High $263.03 | Facility | None | $42.66 | $75.86 | $263.03 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $331.13 | Professional | None | $63.10 | $120.23 | $331.13 |
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 $44.67 Median $83.18 Typical High $128.82 | Professional | None | $44.67 | $83.18 | $128.82 |
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 $30.90 | Facility | 52 · Reduced service | $21.38 | $21.38 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $12.30 | Facility | 53 · Discontinued | $8.71 | $8.71 | $12.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $9.12 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $9.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $6.17 | Facility | 56 · Pre-op care only | $4.27 | $4.37 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $27.54 Typical High $32.36 | Professional | 52 · Reduced service | $21.38 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.96 Typical High $12.88 | Professional | 53 · Discontinued | $8.71 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $6.46 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.50 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.27 | $5.50 | $6.46 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$97.72
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.