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 $79.43 Median $131.83 Typical High $131.83 | Facility | None | $79.43 | $131.83 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $100.00 | Facility | 54 · Surgery only | $60.26 | $60.26 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $181.97 | Professional | None | $79.43 | $131.83 | $181.97 |
BCBS North Dakota Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $338.84 | Professional | None | $144.54 | $213.80 | $338.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $173.78 Median $257.04 Typical High $407.38 | Professional | 22 · Increased work | $173.78 | $257.04 | $407.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $102.33 | $151.36 | $239.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Facility | None | $234.42 | $234.42 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $371.54 | Professional | None | $117.49 | $208.93 | $371.54 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $229.09 Typical High $758.58 | Facility | None | $79.43 | $229.09 | $758.58 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $288.40 | Professional | None | $134.90 | $245.47 | $288.40 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $257.04 | Professional | None | $83.18 | $151.36 | $257.04 |
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 $39.81 Median $39.81 Typical High $66.07 | Facility | 52 · Reduced service | $39.81 | $39.81 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $26.92 | Facility | 53 · Discontinued | $15.85 | $15.85 | $26.92 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $19.95 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $13.18 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $13.18 |
Where North Dakota sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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
$178
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.