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 $25.70 Median $44.67 Typical High $316.23 | Facility | None | $25.70 | $44.67 | $316.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $33.88 | Facility | 54 · Surgery only | $19.50 | $19.50 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $44.67 Typical High $72.44 | Professional | None | $25.70 | $44.67 | $72.44 |
BCBS North Dakota Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $316.23 | Facility | None | $131.83 | $165.96 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $109.65 | Professional | None | $43.65 | $66.07 | $109.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $52.48 Median $79.43 Typical High $131.83 | Professional | 22 · Increased work | $52.48 | $79.43 | $131.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $45.71 Typical High $77.62 | Professional | 54 · Surgery only | $30.90 | $45.71 | $77.62 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $48.98 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $33.11 | $48.98 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $87.10 | Facility | None | $75.86 | $75.86 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $120.23 | Professional | None | $35.48 | $66.07 | $120.23 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $67.61 Typical High $263.03 | Facility | None | $25.70 | $67.61 | $263.03 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $95.50 | Professional | None | $45.71 | $85.11 | $95.50 |
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 $27.54 Median $51.29 Typical High $95.50 | Professional | None | $27.54 | $51.29 | $95.50 |
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 $12.88 Median $12.88 Typical High $22.39 | Facility | 52 · Reduced service | $12.88 | $12.88 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $8.91 | Facility | 53 · Discontinued | $5.25 | $5.25 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $6.76 | Facility | 55 · Aftercare only | $3.89 | $3.89 | $6.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $4.47 | Facility | 56 · Pre-op care only | $2.57 | $2.57 | $4.47 |
Where North Dakota sits
The same service costs 3.4 times more in Wisconsin 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· 20th of 51
$60.26
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.