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 $102.33 Median $154.88 Typical High $478.63 | Facility | None | $102.33 | $154.88 | $478.63 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $117.49 | Facility | 54 · Surgery only | $77.62 | $77.62 | $117.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $109.65 | Facility | 78 · Unplanned return to OR | $72.44 | $72.44 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $204.17 | Professional | None | $102.33 | $131.83 | $204.17 |
BCBS North Dakota Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $3,890.45 | Facility | None | $177.83 | $177.83 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $446.68 | Professional | None | $199.53 | $288.40 | $446.68 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $239.88 Median $346.74 Typical High $537.03 | Professional | 22 · Increased work | $239.88 | $346.74 | $537.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $309.03 | Professional | 54 · Surgery only | $141.25 | $199.53 | $309.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $323.59 Typical High $501.19 | Professional | None | $162.18 | $323.59 | $501.19 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $275.42 | Facility | None | $102.33 | $154.88 | $275.42 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $338.84 | Professional | None | $144.54 | $223.87 | $338.84 |
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 $107.15 Median $181.97 Typical High $288.40 | Professional | None | $107.15 | $181.97 | $288.40 |
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 $51.29 Median $51.29 Typical High $77.62 | Facility | 52 · Reduced service | $51.29 | $51.29 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $31.62 | Facility | 53 · Discontinued | $20.42 | $20.42 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $23.44 | Facility | 55 · Aftercare only | $15.49 | $15.49 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $15.85 | Facility | 56 · Pre-op care only | $10.23 | $10.23 | $15.85 |
Where North Dakota sits
The same service costs 3.6 times more in Alaska 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· 10th of 51
$234
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.