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 $29.51 Median $38.02 Typical High $38.02 | Facility | None | $29.51 | $38.02 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $28.84 | Facility | 54 · Surgery only | $21.88 | $21.88 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $45.71 | Professional | None | $26.92 | $34.67 | $45.71 |
BCBS North Dakota Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $95.50 | Professional | None | $50.12 | $69.18 | $95.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $60.26 Median $83.18 Typical High $114.82 | Professional | 22 · Increased work | $60.26 | $83.18 | $114.82 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $47.86 Typical High $66.07 | Professional | 54 · Surgery only | $35.48 | $47.86 | $66.07 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $51.29 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $38.02 | $51.29 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $72.44 | Facility | None | $63.10 | $63.10 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $114.82 | Professional | None | $40.74 | $64.57 | $114.82 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $54.95 Typical High $263.03 | Facility | None | $29.51 | $54.95 | $263.03 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $83.18 | Professional | None | $39.81 | $70.79 | $83.18 |
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 $30.90 Median $54.95 Typical High $74.13 | Professional | None | $30.90 | $54.95 | $74.13 |
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 $14.79 Median $14.79 Typical High $19.05 | Facility | 52 · Reduced service | $14.79 | $14.79 | $19.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.76 | Facility | 53 · Discontinued | $5.89 | $5.89 | $7.76 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.75 | Facility | 55 · Aftercare only | $4.37 | $4.37 | $5.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.80 | Facility | 56 · Pre-op care only | $2.95 | $2.95 | $3.80 |
Where North Dakota sits
The same service costs 3.3 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· 9th of 51
$61.66
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.