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 $87.10 Median $151.36 Typical High $154.88 | Facility | None | $87.10 | $151.36 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $67.61 Typical High $114.82 | Facility | 54 · Surgery only | $66.07 | $67.61 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $154.88 | Professional | None | $87.10 | $109.65 | $154.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $346.74 | Professional | None | $158.49 | $223.87 | $346.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $190.55 Median $269.15 Typical High $416.87 | Professional | 22 · Increased work | $190.55 | $269.15 | $416.87 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $338.84 Typical High $512.86 | Professional | 50 · Both sides | $239.88 | $338.84 | $512.86 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $154.88 Typical High $239.88 | Professional | 54 · Surgery only | $112.20 | $154.88 | $239.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $165.96 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $120.23 | $165.96 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $331.13 | Professional | None | $117.49 | $199.53 | $331.13 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $154.88 Typical High $269.15 | Facility | None | $87.10 | $154.88 | $269.15 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $331.13 | Professional | None | $162.18 | $263.03 | $331.13 |
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 $93.33 Median $165.96 Typical High $281.84 | Professional | None | $93.33 | $165.96 | $281.84 |
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 $43.65 Median $45.71 Typical High $77.62 | Facility | 52 · Reduced service | $43.65 | $45.71 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $18.20 Typical High $30.90 | Facility | 53 · Discontinued | $17.38 | $18.20 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $22.91 | Facility | 55 · Aftercare only | $13.18 | $13.80 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $15.49 | Facility | 56 · Pre-op care only | $8.71 | $9.12 | $15.49 |
Where North Dakota sits
The same service costs 3.7 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· 15th of 51
$195
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.