How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $51.29 Median $51.29 Typical High $1,995.26 | Facility | None | $51.29 | $51.29 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $91.20 | Professional | None | $51.29 | $51.29 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $67.61 | Professional | 54 · Surgery only | $38.90 | $38.90 | $67.61 |
BCBS North Dakota Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $114.82 | Professional | None | $74.13 | $95.50 | $114.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $89.13 Median $114.82 Typical High $138.04 | Professional | 22 · Increased work | $89.13 | $114.82 | $138.04 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $67.61 Typical High $79.43 | Professional | 54 · Surgery only | $51.29 | $67.61 | $79.43 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $72.44 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $54.95 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $95.50 | Facility | None | $83.18 | $83.18 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $131.83 | Professional | None | $51.29 | $93.33 | $131.83 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $125.89 Typical High $269.15 | Facility | None | $51.29 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $478.63 | Professional | None | $52.48 | $93.33 | $478.63 |
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 $48.98 Median $69.18 Typical High $107.15 | Professional | None | $48.98 | $69.18 | $107.15 |
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 Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 52 · Reduced service | $25.70 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $18.20 | Professional | 53 · Discontinued | $10.23 | $10.23 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $13.49 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $9.12 |
Where North Dakota sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 10th of 51
$91.20
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.