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 $9.12 Median $28.18 Typical High $36.31 | Facility | None | $9.12 | $28.18 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $6.92 Median $7.59 Typical High $21.38 | Facility | 54 · Surgery only | $6.92 | $7.59 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $12.30 Typical High $36.31 | Professional | None | $9.12 | $12.30 | $36.31 |
BCBS North Dakota Setting Professional Modifier None Typical Low $15.85 Median $23.99 Typical High $75.86 | Professional | None | $15.85 | $23.99 | $75.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $19.05 Median $28.84 Typical High $91.20 | Professional | 22 · Increased work | $19.05 | $28.84 | $91.20 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $16.60 Typical High $53.70 | Professional | 54 · Surgery only | $11.22 | $16.60 | $53.70 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $12.02 Median $17.78 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $12.02 | $17.78 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Facility | None | $54.95 | $54.95 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $47.86 Typical High $100.00 | Professional | None | $13.18 | $47.86 | $100.00 |
Medica Setting Facility Modifier None Typical Low $9.12 Median $38.90 Typical High $263.03 | Facility | None | $9.12 | $38.90 | $263.03 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $61.66 | Professional | None | $28.18 | $48.98 | $61.66 |
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 $9.33 Median $25.12 Typical High $51.29 | Professional | None | $9.33 | $25.12 | $51.29 |
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 $4.57 Median $5.01 Typical High $14.13 | Facility | 52 · Reduced service | $4.57 | $5.01 | $14.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.82 Median $2.00 Typical High $5.62 | Facility | 53 · Discontinued | $1.82 | $2.00 | $5.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.38 Median $1.51 Typical High $4.27 | Facility | 55 · Aftercare only | $1.38 | $1.51 | $4.27 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.91 Median $1.00 Typical High $2.82 | Facility | 56 · Pre-op care only | $0.91 | $1.00 | $2.82 |
Where North Dakota sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 38th of 51
$28.18
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.