How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $134.90 Median $134.90 Typical High $1,995.26 | Facility | None | $134.90 | $134.90 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $162.18 | Professional | None | $125.89 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $95.50 | $102.33 | $123.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $323.59 | Professional | None | $213.80 | $275.42 | $323.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $257.04 Median $331.13 Typical High $389.05 | Professional | 22 · Increased work | $257.04 | $331.13 | $389.05 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $190.55 | $223.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $204.17 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $158.49 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $354.81 | Professional | None | $138.04 | $257.04 | $354.81 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $758.58 Typical High $1,778.28 | Facility | None | $134.90 | $758.58 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $1,862.09 | Professional | None | $125.89 | $251.19 | $1,862.09 |
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 $114.82 Median $194.98 Typical High $281.84 | Professional | None | $114.82 | $194.98 | $281.84 |
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 Professional Modifier 52 · Reduced service Typical Low $63.10 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $19.05 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $16.22 |
Where North Dakota sits
The same service costs 5.4 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· 16th of 51
$251
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.