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 $131.83 Median $263.03 Typical High $263.03 | Facility | None | $131.83 | $263.03 | $263.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $199.53 | Facility | 54 · Surgery only | $100.00 | $109.65 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $302.00 | Professional | None | $131.83 | $151.36 | $302.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $660.69 | Professional | None | $234.42 | $354.81 | $660.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $281.84 Median $426.58 Typical High $794.33 | Professional | 22 · Increased work | $281.84 | $426.58 | $794.33 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $524.81 Typical High $1,000.00 | Professional | 50 · Both sides | $346.74 | $524.81 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $245.47 Typical High $467.74 | Professional | 54 · Surgery only | $162.18 | $245.47 | $467.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $263.03 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $173.78 | $263.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $741.31 | Professional | None | $218.78 | $407.38 | $741.31 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $251.19 Typical High $446.68 | Facility | None | $131.83 | $251.19 | $446.68 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $562.34 | Professional | None | $269.15 | $478.63 | $562.34 |
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 $138.04 Median $269.15 Typical High $524.81 | Professional | None | $138.04 | $269.15 | $524.81 |
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 $66.07 Median $72.44 Typical High $131.83 | Facility | 52 · Reduced service | $66.07 | $72.44 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $52.48 | Facility | 53 · Discontinued | $26.30 | $28.84 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $39.81 | Facility | 55 · Aftercare only | $19.95 | $21.88 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $26.30 | Facility | 56 · Pre-op care only | $13.18 | $14.45 | $26.30 |
Where North Dakota sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 27th of 51
$282
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.