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 $102.33 Median $102.33 Typical High $1,995.26 | Facility | None | $102.33 | $102.33 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $173.78 | Professional | None | $102.33 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $128.82 | Professional | 54 · Surgery only | $77.62 | $77.62 | $128.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $223.87 | Professional | None | $144.54 | $186.21 | $223.87 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $173.78 Median $223.87 Typical High $269.15 | Professional | 22 · Increased work | $173.78 | $223.87 | $269.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $131.83 Typical High $154.88 | Professional | 54 · Surgery only | $102.33 | $131.83 | $154.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Facility | None | $162.18 | $162.18 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $257.04 | Professional | None | $100.00 | $181.97 | $257.04 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $269.15 | Facility | None | $102.33 | $173.78 | $269.15 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $724.44 | Professional | None | $104.71 | $186.21 | $724.44 |
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 $97.72 Median $138.04 Typical High $213.80 | Professional | None | $97.72 | $138.04 | $213.80 |
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 $51.29 Median $51.29 Typical High $87.10 | Professional | 52 · Reduced service | $51.29 | $51.29 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $34.67 | Professional | 53 · Discontinued | $20.42 | $20.42 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $25.70 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $17.38 |
Where North Dakota sits
The same service costs 4.0 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· 11th of 51
$170
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.