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 $15.85 Median $30.20 Typical High $134.90 | Facility | None | $15.85 | $30.20 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $11.75 Median $12.59 Typical High $22.91 | Facility | 54 · Surgery only | $11.75 | $12.59 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $31.62 | Professional | None | $14.45 | $20.42 | $31.62 |
BCBS North Dakota Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $208.93 | Facility | None | $138.04 | $186.21 | $208.93 |
BCBS North Dakota Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $66.07 | Professional | None | $25.70 | $38.90 | $66.07 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $30.90 Median $46.77 Typical High $79.43 | Professional | 22 · Increased work | $30.90 | $46.77 | $79.43 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $26.92 Typical High $46.77 | Professional | 54 · Surgery only | $18.20 | $26.92 | $46.77 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.50 Median $28.84 Typical High $50.12 | Professional | 78 · Unplanned return to OR | $19.50 | $28.84 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $54.95 | Facility | None | $47.86 | $47.86 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $75.86 | Professional | None | $24.55 | $41.69 | $75.86 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $40.74 Typical High $251.19 | Facility | None | $15.85 | $40.74 | $251.19 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $63.10 | Professional | None | $30.90 | $57.54 | $63.10 |
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 $16.22 Median $30.90 Typical High $63.10 | Professional | None | $16.22 | $30.90 | $63.10 |
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 $7.76 Median $8.32 Typical High $15.14 | Facility | 52 · Reduced service | $7.76 | $8.32 | $15.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $3.31 Typical High $6.17 | Facility | 53 · Discontinued | $3.16 | $3.31 | $6.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.34 Median $2.51 Typical High $4.57 | Facility | 55 · Aftercare only | $2.34 | $2.51 | $4.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.66 Typical High $3.02 | Facility | 56 · Pre-op care only | $1.58 | $1.66 | $3.02 |
Where North Dakota sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 19th of 51
$35.48
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.