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 $295.12 Median $363.08 Typical High $389.05 | Facility | None | $295.12 | $363.08 | $389.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $288.40 | Facility | 54 · Surgery only | $223.87 | $223.87 | $288.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $38.90 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $269.15 | Facility | 78 · Unplanned return to OR | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $446.68 | Professional | None | $281.84 | $363.08 | $446.68 |
BCBS North Dakota Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $933.25 | Professional | None | $524.81 | $676.08 | $933.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $630.96 Median $812.83 Typical High $1,122.02 | Professional | 22 · Increased work | $630.96 | $812.83 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $478.63 Typical High $645.65 | Professional | 54 · Surgery only | $371.54 | $478.63 | $645.65 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $93.33 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $93.33 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $512.86 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $398.11 | $512.86 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,174.90 | Professional | None | $426.58 | $691.83 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $537.03 Typical High $2,511.89 | Facility | None | $295.12 | $537.03 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $831.76 | Professional | None | $389.05 | $707.95 | $831.76 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $302.00 Median $549.54 Typical High $794.33 | Professional | None | $302.00 | $549.54 | $794.33 |
3 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 $147.91 Median $147.91 Typical High $194.98 | Facility | 52 · Reduced service | $147.91 | $147.91 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $77.62 | Facility | 53 · Discontinued | $58.88 | $58.88 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $57.54 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $57.54 |
Where North Dakota sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 11th of 51
$631
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.