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 $50.12 Median $120.23 Typical High $120.23 | Facility | None | $50.12 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $114.82 Typical High $154.88 | Professional | None | $47.86 | $114.82 | $154.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $309.03 | Professional | None | $93.33 | $141.25 | $309.03 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $112.20 Median $169.82 Typical High $371.54 | Professional | 22 · Increased work | $112.20 | $169.82 | $371.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $213.80 Typical High $467.74 | Professional | 50 · Both sides | $141.25 | $213.80 | $467.74 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $100.00 Typical High $218.78 | Professional | 54 · Surgery only | $64.57 | $100.00 | $218.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $107.15 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $69.18 | $107.15 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $346.74 | Professional | None | $53.70 | $134.90 | $346.74 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $120.23 Typical High $204.17 | Facility | None | $50.12 | $120.23 | $204.17 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $1,000.00 Typical High $3,388.44 | Professional | None | $128.82 | $1,000.00 | $3,388.44 |
United Setting Professional Modifier None Typical Low $52.48 Median $120.23 Typical High $229.09 | Professional | None | $52.48 | $120.23 | $229.09 |
8 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 $25.12 Median $25.12 Typical High $58.88 | Facility | 52 · Reduced service | $25.12 | $25.12 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $23.99 | Facility | 53 · Discontinued | $10.23 | $10.23 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $17.78 | Facility | 55 · Aftercare only | $7.59 | $7.59 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $12.02 | Facility | 56 · Pre-op care only | $5.13 | $5.13 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $33.88 Typical High $69.18 | Professional | 52 · Reduced service | $23.99 | $33.88 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.80 Typical High $27.54 | Professional | 53 · Discontinued | $9.55 | $13.80 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.23 Typical High $20.89 | Professional | 55 · Aftercare only | $7.24 | $10.23 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.92 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.79 | $6.92 | $13.80 |
Where North Dakota sits
The same service costs 2.7 times more in Wisconsin than in Maryland. 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· 22nd of 51
$132
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.