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 $8.91 Median $10.00 Typical High $16.60 | Facility | None | $8.91 | $10.00 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $10.00 Typical High $19.95 | Professional | None | $8.91 | $10.00 | $19.95 |
BCBS North Dakota Setting Professional Modifier None Typical Low $15.49 Median $22.91 Typical High $44.67 | Professional | None | $15.49 | $22.91 | $44.67 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $18.20 Median $27.54 Typical High $53.70 | Professional | 22 · Increased work | $18.20 | $27.54 | $53.70 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $15.85 Typical High $31.62 | Professional | 54 · Surgery only | $10.72 | $15.85 | $31.62 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $11.48 Median $16.98 Typical High $33.88 | Professional | 78 · Unplanned return to OR | $11.48 | $16.98 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $35.48 | Facility | None | $30.90 | $30.90 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $26.30 Typical High $56.23 | Professional | None | $12.59 | $26.30 | $56.23 |
Medica Setting Facility Modifier None Typical Low $8.91 Median $16.60 Typical High $28.84 | Facility | None | $8.91 | $16.60 | $28.84 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $35.48 Typical High $37.15 | Professional | None | $16.98 | $35.48 | $37.15 |
United Setting Professional Modifier None Typical Low $9.12 Median $18.20 Typical High $37.15 | Professional | None | $9.12 | $18.20 | $37.15 |
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 $4.47 Median $4.90 Typical High $8.32 | Facility | 52 · Reduced service | $4.47 | $4.90 | $8.32 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.78 Median $2.00 Typical High $3.39 | Facility | 53 · Discontinued | $1.78 | $2.00 | $3.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.32 Median $1.48 Typical High $2.51 | Facility | 55 · Aftercare only | $1.32 | $1.48 | $2.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.00 Typical High $1.70 | Facility | 56 · Pre-op care only | $0.87 | $1.00 | $1.70 |
Where North Dakota sits
The same service costs 3.2 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· 25th of 51
$18.62
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.