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 $63.10 Median $97.72 Typical High $416.87 | Facility | None | $63.10 | $97.72 | $416.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $72.44 | Facility | 54 · Surgery only | $47.86 | $47.86 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $131.83 | Professional | None | $63.10 | $97.72 | $131.83 |
BCBS North Dakota Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $2,511.89 | Facility | None | $239.88 | $239.88 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $239.88 | Professional | None | $109.65 | $158.49 | $239.88 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $131.83 Median $190.55 Typical High $288.40 | Professional | 22 · Increased work | $131.83 | $190.55 | $288.40 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $112.20 Typical High $165.96 | Professional | 54 · Surgery only | $77.62 | $112.20 | $165.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $120.23 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $83.18 | $120.23 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Facility | None | $169.82 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $263.03 | Professional | None | $97.72 | $162.18 | $263.03 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $125.89 Typical High $263.03 | Facility | None | $63.10 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $218.78 | Professional | None | $100.00 | $194.98 | $218.78 |
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 $67.61 Median $141.25 Typical High $218.78 | Professional | None | $67.61 | $141.25 | $218.78 |
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 $31.62 Median $31.62 Typical High $48.98 | Facility | 52 · Reduced service | $31.62 | $31.62 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $19.50 | Facility | 53 · Discontinued | $12.59 | $12.59 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $14.79 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $9.77 | Facility | 56 · Pre-op care only | $6.31 | $6.31 | $9.77 |
Where North Dakota sits
The same service costs 3.0 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· 14th of 51
$138
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.