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 $165.96 Median $251.19 Typical High $457.09 | Facility | None | $165.96 | $251.19 | $457.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $134.90 Typical High $186.21 | Facility | 54 · Surgery only | $123.03 | $134.90 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $346.74 | Professional | None | $165.96 | $245.47 | $346.74 |
BCBS North Dakota Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Facility | None | $2,137.96 | $2,137.96 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $630.96 | Professional | None | $288.40 | $426.58 | $630.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $512.86 Typical High $758.58 | Professional | 22 · Increased work | $346.74 | $512.86 | $758.58 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $630.96 Typical High $954.99 | Professional | 50 · Both sides | $426.58 | $630.96 | $954.99 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $446.68 | Professional | 54 · Surgery only | $199.53 | $295.12 | $446.68 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $213.80 | $316.23 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Facility | None | $446.68 | $446.68 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $691.83 | Professional | None | $239.88 | $436.52 | $691.83 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $426.58 Typical High $1,202.26 | Facility | None | $165.96 | $426.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $537.03 | Professional | None | $257.04 | $457.09 | $537.03 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $512.86 | Professional | None | $173.78 | $316.23 | $512.86 |
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 $83.18 Median $89.13 Typical High $125.89 | Facility | 52 · Reduced service | $83.18 | $89.13 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $35.48 Typical High $50.12 | Facility | 53 · Discontinued | $33.11 | $35.48 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $26.92 Typical High $37.15 | Facility | 55 · Aftercare only | $24.55 | $26.92 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $25.12 | Facility | 56 · Pre-op care only | $16.60 | $17.78 | $25.12 |
Where North Dakota sits
The same service costs 3.1 times more in Alaska than in New York. 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· 19th of 51
$363
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.