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 $52.48 Median $100.00 Typical High $3,981.07 | Facility | None | $52.48 | $100.00 | $3,981.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $69.18 | Facility | 54 · Surgery only | $38.90 | $38.90 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $117.49 | Professional | None | $46.77 | $67.61 | $117.49 |
BCBS North Dakota Setting Facility Modifier None Typical Low $102.33 Median $288.40 Typical High $630.96 | Facility | None | $102.33 | $288.40 | $630.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $257.04 | Professional | None | $87.10 | $131.83 | $257.04 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $104.71 Median $158.49 Typical High $309.03 | Professional | 22 · Increased work | $104.71 | $158.49 | $309.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $91.20 Typical High $177.83 | Professional | 54 · Surgery only | $61.66 | $91.20 | $177.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $97.72 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $66.07 | $97.72 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Facility | None | $190.55 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $162.18 Typical High $338.84 | Professional | None | $72.44 | $162.18 | $338.84 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $125.89 Typical High $489.78 | Facility | None | $52.48 | $125.89 | $489.78 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $199.53 | Professional | None | $85.11 | $134.90 | $199.53 |
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 $53.70 Median $100.00 Typical High $165.96 | Professional | None | $53.70 | $100.00 | $165.96 |
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 $26.30 Median $26.30 Typical High $45.71 | Facility | 52 · Reduced service | $26.30 | $26.30 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $18.62 | Facility | 53 · Discontinued | $10.47 | $10.47 | $18.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $13.80 | Facility | 55 · Aftercare only | $7.76 | $7.76 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $9.12 | Facility | 56 · Pre-op care only | $5.25 | $5.25 | $9.12 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in New York. 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· 15th of 51
$117
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.