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 $229.09 Median $229.09 Typical High $1,995.26 | Facility | None | $229.09 | $229.09 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $275.42 | Professional | None | $213.80 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $158.49 | $173.78 | $208.93 |
BCBS North Dakota Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $537.03 | Professional | None | $354.81 | $457.09 | $537.03 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $426.58 Median $549.54 Typical High $645.65 | Professional | 22 · Increased work | $426.58 | $549.54 | $645.65 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $251.19 | $323.59 | $380.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $346.74 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $602.56 | Professional | None | $234.42 | $457.09 | $602.56 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $758.58 Typical High $1,698.24 | Facility | None | $229.09 | $758.58 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $407.38 Typical High $1,698.24 | Professional | None | $194.98 | $407.38 | $1,698.24 |
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 $194.98 Median $309.03 Typical High $467.74 | Professional | None | $194.98 | $309.03 | $467.74 |
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 $107.15 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $107.15 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $42.66 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $27.54 |
Where North Dakota sits
The same service costs 4.7 times more in Wyoming 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· 12th of 51
$417
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.