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 $109.65 Median $109.65 Typical High $2,511.89 | Facility | None | $109.65 | $109.65 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $288.40 | Professional | None | $109.65 | $109.65 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $81.28 Typical High $141.25 | Professional | 54 · Surgery only | $79.43 | $81.28 | $141.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $239.88 | Professional | None | $154.88 | $204.17 | $239.88 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $186.21 Median $245.47 Typical High $288.40 | Professional | 22 · Increased work | $186.21 | $245.47 | $288.40 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $109.65 | $141.25 | $165.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $208.93 | Facility | None | $181.97 | $181.97 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $288.40 | Professional | None | $109.65 | $199.53 | $288.40 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $269.15 | Facility | None | $109.65 | $151.36 | $269.15 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $891.25 | Professional | None | $104.71 | $173.78 | $891.25 |
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 $89.13 Median $134.90 Typical High $199.53 | Professional | None | $89.13 | $134.90 | $199.53 |
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 $53.70 Median $54.95 Typical High $93.33 | Professional | 52 · Reduced service | $53.70 | $54.95 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $38.02 | Professional | 53 · Discontinued | $21.38 | $21.88 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $28.18 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $18.62 |
Where North Dakota sits
The same service costs 4.8 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
$182
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.