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 $91.20 Median $128.82 Typical High $128.82 | Facility | None | $91.20 | $128.82 | $128.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $72.44 Typical High $95.50 | Facility | 54 · Surgery only | $69.18 | $72.44 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $138.04 | Professional | None | $91.20 | $102.33 | $138.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $323.59 | Professional | None | $162.18 | $229.09 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $194.98 Median $275.42 Typical High $389.05 | Professional | 22 · Increased work | $194.98 | $275.42 | $389.05 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $114.82 | $158.49 | $229.09 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $169.82 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $123.03 | $169.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $251.19 | Facility | None | $218.78 | $218.78 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $338.84 | Professional | None | $131.83 | $218.78 | $338.84 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $162.18 Typical High $660.69 | Facility | None | $91.20 | $162.18 | $660.69 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $275.42 | Professional | None | $128.82 | $234.42 | $275.42 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $257.04 | Professional | None | $95.50 | $165.96 | $257.04 |
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 $45.71 Median $47.86 Typical High $64.57 | Facility | 52 · Reduced service | $45.71 | $47.86 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $25.70 | Facility | 53 · Discontinued | $18.62 | $19.50 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $19.05 | Facility | 55 · Aftercare only | $13.80 | $14.45 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $12.88 | Facility | 56 · Pre-op care only | $9.12 | $9.55 | $12.88 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 14th of 51
$200
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.