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 $177.83 Median $223.87 Typical High $223.87 | Facility | None | $177.83 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $165.96 | Facility | 54 · Surgery only | $134.90 | $134.90 | $165.96 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $239.88 | Professional | None | $173.78 | $208.93 | $239.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $588.84 | Professional | None | $331.13 | $426.58 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $512.86 Typical High $707.95 | Professional | 22 · Increased work | $398.11 | $512.86 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $302.00 Typical High $407.38 | Professional | 54 · Surgery only | $229.09 | $302.00 | $407.38 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $245.47 | $323.59 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Facility | None | $416.87 | $416.87 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $660.69 | Professional | None | $269.15 | $436.52 | $660.69 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $2,511.89 | Facility | None | $177.83 | $346.74 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $478.63 | Professional | None | $223.87 | $363.08 | $478.63 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $426.58 | Professional | None | $186.21 | $331.13 | $426.58 |
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 $89.13 Median $89.13 Typical High $112.20 | Facility | 52 · Reduced service | $89.13 | $89.13 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $44.67 | Facility | 53 · Discontinued | $36.31 | $36.31 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $33.11 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $22.39 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $22.39 |
Where North Dakota sits
The same service costs 4.4 times more in Alaska 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· 8th of 51
$389
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.