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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | None | $95.50 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $77.62 Typical High $91.20 | Professional | 54 · Surgery only | $70.79 | $77.62 | $91.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $257.04 | Professional | None | $165.96 | $218.78 | $257.04 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $199.53 Median $257.04 Typical High $309.03 | Professional | 22 · Increased work | $199.53 | $257.04 | $309.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $117.49 | $151.36 | $177.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $190.55 | Facility | None | $165.96 | $165.96 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $263.03 | Professional | None | $109.65 | $186.21 | $263.03 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $676.08 Typical High $2,344.23 | Facility | None | $104.71 | $676.08 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $1,071.52 | Professional | None | $91.20 | $177.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Facility | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $208.93 | Professional | None | $85.11 | $141.25 | $208.93 |
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 $47.86 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $47.86 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $19.05 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $14.13 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.47 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.55 | $10.47 | $12.02 |
Where North Dakota sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 9th of 51
$191
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.