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 $213.80 Median $281.84 Typical High $302.00 | Facility | None | $213.80 | $281.84 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $223.87 | Facility | 54 · Surgery only | $158.49 | $158.49 | $223.87 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $302.00 | Professional | None | $194.98 | $213.80 | $302.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $707.95 | Professional | None | $363.08 | $512.86 | $707.95 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $436.52 Median $616.60 Typical High $851.14 | Professional | 22 · Increased work | $436.52 | $616.60 | $851.14 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $354.81 Typical High $501.19 | Professional | 54 · Surgery only | $257.04 | $354.81 | $501.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $380.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $275.42 | $380.19 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Facility | None | $501.19 | $501.19 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $794.33 | Professional | None | $338.84 | $512.86 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $512.86 | Facility | None | $125.89 | $263.03 | $512.86 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $660.69 | Professional | None | $309.03 | $588.84 | $660.69 |
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 $218.78 Median $426.58 Typical High $660.69 | Professional | None | $218.78 | $426.58 | $660.69 |
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 $107.15 Median $107.15 Typical High $151.36 | Facility | 52 · Reduced service | $107.15 | $107.15 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $60.26 | Facility | 53 · Discontinued | $42.66 | $42.66 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $45.71 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $30.20 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $30.20 |
Where North Dakota sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$437
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.