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 $46.77 Median $67.61 Typical High $67.61 | Facility | None | $46.77 | $67.61 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $51.29 | Facility | 54 · Surgery only | $34.67 | $34.67 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $95.50 | Professional | None | $41.69 | $67.61 | $95.50 |
BCBS North Dakota Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $169.82 | Professional | None | $81.28 | $117.49 | $169.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $97.72 Median $141.25 Typical High $204.17 | Professional | 22 · Increased work | $97.72 | $141.25 | $204.17 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $81.28 Typical High $120.23 | Professional | 54 · Surgery only | $56.23 | $81.28 | $120.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $87.10 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $60.26 | $87.10 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Facility | None | $125.89 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $229.09 | Professional | None | $64.57 | $123.03 | $229.09 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $81.28 Typical High $263.03 | Facility | None | $46.77 | $81.28 | $263.03 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $151.36 | Professional | None | $70.79 | $138.04 | $151.36 |
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 $48.98 Median $87.10 Typical High $151.36 | Professional | None | $48.98 | $87.10 | $151.36 |
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 $22.91 Median $22.91 Typical High $33.88 | Facility | 52 · Reduced service | $22.91 | $22.91 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $13.80 | Facility | 53 · Discontinued | $9.33 | $9.33 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.23 | Facility | 55 · Aftercare only | $6.92 | $6.92 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $6.76 | Facility | 56 · Pre-op care only | $4.68 | $4.68 | $6.76 |
Where North Dakota sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 11th of 51
$100
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.