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 $70.79 Median $117.49 Typical High $125.89 | Facility | None | $70.79 | $117.49 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $95.50 | Facility | 54 · Surgery only | $53.70 | $53.70 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $125.89 | Professional | None | $66.07 | $87.10 | $125.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $295.12 | Professional | None | $112.20 | $181.97 | $295.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $134.90 Median $218.78 Typical High $354.81 | Professional | 22 · Increased work | $134.90 | $218.78 | $354.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $125.89 Typical High $204.17 | Professional | 54 · Surgery only | $77.62 | $125.89 | $204.17 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $134.90 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $83.18 | $134.90 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Facility | None | $213.80 | $213.80 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $331.13 | Professional | None | $114.82 | $186.21 | $331.13 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $125.89 Typical High $263.03 | Facility | None | $70.79 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $512.86 | Professional | None | $128.82 | $245.47 | $512.86 |
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 $72.44 Median $144.54 Typical High $257.04 | Professional | None | $72.44 | $144.54 | $257.04 |
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 $35.48 Median $35.48 Typical High $63.10 | Facility | 52 · Reduced service | $35.48 | $35.48 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $25.12 | Facility | 53 · Discontinued | $14.13 | $14.13 | $25.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $19.05 | Facility | 55 · Aftercare only | $10.72 | $10.72 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $12.59 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $12.59 |
Where North Dakota sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 13th of 51
$151
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.