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 $114.82 Median $114.82 Typical High $1,995.26 | Facility | None | $114.82 | $114.82 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $144.54 | Professional | None | $104.71 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $85.11 Typical High $109.65 | Professional | 54 · Surgery only | $79.43 | $85.11 | $109.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $295.12 | Professional | None | $194.98 | $251.19 | $295.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $234.42 Median $302.00 Typical High $354.81 | Professional | 22 · Increased work | $234.42 | $302.00 | $354.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $134.90 | $173.78 | $204.17 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $144.54 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Facility | None | $190.55 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $302.00 | Professional | None | $120.23 | $208.93 | $302.00 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $1,995.26 Typical High $3,235.94 | Facility | None | $114.82 | $1,995.26 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $851.14 | Professional | None | $93.33 | $194.98 | $851.14 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $229.09 | Professional | None | $93.33 | $158.49 | $229.09 |
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 $52.48 Median $57.54 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $21.88 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $14.45 |
Where North Dakota sits
The same service costs 4.8 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· 10th of 51
$219
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.