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 $151.36 Median $1,513.56 Typical High $1,698.24 | Facility | None | $151.36 | $1,513.56 | $1,698.24 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $117.49 Typical High $1,288.25 | Facility | 54 · Surgery only | $112.20 | $117.49 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $1,905.46 | Professional | None | $147.91 | $288.40 | $1,905.46 |
BCBS North Dakota Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $3,235.94 | Professional | None | $263.03 | $398.11 | $3,235.94 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $316.23 Median $478.63 Typical High $3,890.45 | Professional | 22 · Increased work | $316.23 | $478.63 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $588.84 Typical High $4,897.79 | Professional | 50 · Both sides | $398.11 | $588.84 | $4,897.79 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $2,290.87 | Professional | 54 · Surgery only | $186.21 | $275.42 | $2,290.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $295.12 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $199.53 | $295.12 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,630.27 | Facility | None | $2,290.87 | $2,290.87 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $467.74 Typical High $3,311.31 | Professional | None | $204.17 | $467.74 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $1,023.29 Typical High $2,137.96 | Facility | None | $151.36 | $1,023.29 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $3,162.28 Typical High $3,715.35 | Professional | None | $1,737.80 | $3,162.28 | $3,715.35 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $162.18 Median $1,548.82 Typical High $3,388.44 | Professional | None | $162.18 | $1,548.82 | $3,388.44 |
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 $75.86 Median $79.43 Typical High $851.14 | Facility | 52 · Reduced service | $75.86 | $79.43 | $851.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $338.84 | Facility | 53 · Discontinued | $30.20 | $31.62 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $257.04 | Facility | 55 · Aftercare only | $22.91 | $23.44 | $257.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $169.82 | Facility | 56 · Pre-op care only | $15.14 | $15.85 | $169.82 |
Where North Dakota sits
The same service costs 8.5 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· 16th of 51
$1,549
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.