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 $72.44 Median $109.65 Typical High $112.20 | Facility | None | $72.44 | $109.65 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $11.22 | Facility | 56 · Pre-op care only | $7.24 | $7.24 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $125.89 | Professional | None | $63.10 | $100.00 | $125.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $295.12 | Professional | None | $123.03 | $186.21 | $295.12 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.30 | $18.62 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $354.81 | Professional | None | $173.78 | $213.80 | $354.81 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $218.78 | Facility | None | $72.44 | $112.20 | $218.78 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $831.76 | Professional | None | $229.09 | $295.12 | $831.76 |
United Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $302.00 | Professional | None | $131.83 | $194.98 | $302.00 |
7 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 $36.31 Median $36.31 Typical High $56.23 | Facility | 52 · Reduced service | $36.31 | $36.31 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $22.39 | Facility | 53 · Discontinued | $14.45 | $14.45 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $16.98 | Facility | 55 · Aftercare only | $10.96 | $10.96 | $16.98 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $223.87 Typical High $354.81 | Professional | 22 · Increased work | $147.91 | $223.87 | $354.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $85.11 | $128.82 | $204.17 |
BCBS North Dakota Setting Professional Modifier 66 · Surgical team Typical Low $75.86 Median $114.82 Typical High $181.97 | Professional | 66 · Surgical team | $75.86 | $114.82 | $181.97 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $138.04 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $91.20 | $138.04 | $218.78 |
Where North Dakota sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 31st of 51
$145
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.