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 $107.15 Median $245.47 Typical High $245.47 | Facility | None | $107.15 | $245.47 | $245.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $85.11 Typical High $181.97 | Facility | 54 · Surgery only | $81.28 | $85.11 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $263.03 | Professional | None | $107.15 | $138.04 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $630.96 | Professional | None | $194.98 | $295.12 | $630.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $234.42 Median $346.74 Typical High $758.58 | Professional | 22 · Increased work | $234.42 | $346.74 | $758.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $436.52 | Professional | 54 · Surgery only | $138.04 | $204.17 | $436.52 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $218.78 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $147.91 | $218.78 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Facility | None | $389.05 | $389.05 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $309.03 Typical High $707.95 | Professional | None | $147.91 | $309.03 | $707.95 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $323.59 Typical High $758.58 | Facility | None | $107.15 | $323.59 | $758.58 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $524.81 | Professional | None | $229.09 | $398.11 | $524.81 |
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 $117.49 Median $239.88 Typical High $446.68 | Professional | None | $117.49 | $239.88 | $446.68 |
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 $53.70 Median $57.54 Typical High $123.03 | Facility | 52 · Reduced service | $53.70 | $57.54 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $22.91 Typical High $48.98 | Facility | 53 · Discontinued | $21.38 | $22.91 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $37.15 | Facility | 55 · Aftercare only | $16.22 | $16.98 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.48 Typical High $24.55 | Facility | 56 · Pre-op care only | $10.72 | $11.48 | $24.55 |
Where North Dakota sits
The same service costs 4.3 times more in Alaska 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· 35th of 51
$263
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.