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 $85.11 Median $190.55 Typical High $190.55 | Facility | None | $85.11 | $190.55 | $190.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $69.18 Typical High $141.25 | Facility | 54 · Surgery only | $64.57 | $69.18 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $251.19 | Professional | None | $85.11 | $128.82 | $251.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $524.81 | Professional | None | $158.49 | $234.42 | $524.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $190.55 Median $281.84 Typical High $616.60 | Professional | 22 · Increased work | $190.55 | $281.84 | $616.60 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $165.96 Typical High $363.08 | Professional | 54 · Surgery only | $109.65 | $165.96 | $363.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $467.74 | Professional | None | $120.23 | $251.19 | $467.74 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $263.03 Typical High $758.58 | Facility | None | $85.11 | $263.03 | $758.58 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $389.05 Typical High $416.87 | Professional | None | $194.98 | $389.05 | $416.87 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $416.87 | Professional | None | $87.10 | $213.80 | $416.87 |
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 $42.66 Median $46.77 Typical High $95.50 | Facility | 52 · Reduced service | $42.66 | $46.77 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $38.02 | Facility | 53 · Discontinued | $16.98 | $18.62 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $28.84 | Facility | 55 · Aftercare only | $12.88 | $13.80 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $19.05 | Facility | 56 · Pre-op care only | $8.51 | $9.33 | $19.05 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska 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· 46th of 51
$214
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.