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 $120.23 Median $194.98 Typical High $199.53 | Facility | None | $120.23 | $194.98 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $151.36 | Facility | 54 · Surgery only | $89.13 | $89.13 | $151.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $141.25 | Facility | 78 · Unplanned return to OR | $83.18 | $83.18 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $199.53 | Professional | None | $114.82 | $128.82 | $199.53 |
BCBS North Dakota Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $512.86 | Professional | None | $229.09 | $316.23 | $512.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $275.42 Median $380.19 Typical High $616.60 | Professional | 22 · Increased work | $275.42 | $380.19 | $616.60 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $223.87 Typical High $354.81 | Professional | 54 · Surgery only | $162.18 | $223.87 | $354.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $239.88 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $173.78 | $239.88 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Facility | None | $346.74 | $346.74 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $616.60 | Professional | None | $177.83 | $323.59 | $616.60 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $1,096.48 | Facility | None | $120.23 | $208.93 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $426.58 | Professional | None | $204.17 | $354.81 | $426.58 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $371.54 | Professional | None | $123.03 | $223.87 | $371.54 |
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 $58.88 Median $58.88 Typical High $100.00 | Facility | 52 · Reduced service | $58.88 | $58.88 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $39.81 | Facility | 53 · Discontinued | $23.99 | $23.99 | $39.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $30.20 | Facility | 55 · Aftercare only | $17.78 | $17.78 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $19.95 | Facility | 56 · Pre-op care only | $12.02 | $12.02 | $19.95 |
Where North Dakota sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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
$282
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.