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 $30.90 Median $75.86 Typical High $870.96 | Facility | None | $30.90 | $75.86 | $870.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $56.23 | Facility | 54 · Surgery only | $22.91 | $22.91 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $64.57 Typical High $104.71 | Professional | None | $30.90 | $64.57 | $104.71 |
BCBS North Dakota Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Facility | None | $354.81 | $354.81 | $371.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $190.55 | Professional | None | $52.48 | $77.62 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $61.66 Median $93.33 Typical High $229.09 | Professional | 22 · Increased work | $61.66 | $93.33 | $229.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $53.70 Typical High $131.83 | Professional | 54 · Surgery only | $36.31 | $53.70 | $131.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $57.54 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $38.90 | $57.54 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $151.36 | Facility | None | $131.83 | $131.83 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $97.72 Typical High $208.93 | Professional | None | $47.86 | $97.72 | $208.93 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $79.43 Typical High $263.03 | Facility | None | $30.90 | $79.43 | $263.03 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $162.18 | Professional | None | $77.62 | $138.04 | $162.18 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $32.36 Median $74.13 Typical High $147.91 | Professional | None | $32.36 | $74.13 | $147.91 |
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 Facility Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $38.02 | Facility | 52 · Reduced service | $15.49 | $15.49 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $15.14 | Facility | 53 · Discontinued | $6.17 | $6.17 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $11.22 | Facility | 55 · Aftercare only | $4.57 | $4.57 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $7.59 | Facility | 56 · Pre-op care only | $3.09 | $3.09 | $7.59 |
Where North Dakota sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 40th of 51
$77.62
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.