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 $12.30 Median $12.30 Typical High $15.14 | Facility | None | $12.30 | $12.30 | $15.14 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $9.33 Median $9.33 Typical High $11.48 | Facility | 54 · Surgery only | $9.33 | $9.33 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $18.62 | Professional | None | $12.02 | $14.13 | $18.62 |
BCBS North Dakota Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $35.48 | Professional | None | $20.42 | $26.92 | $35.48 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $24.55 Median $31.62 Typical High $42.66 | Professional | 22 · Increased work | $24.55 | $31.62 | $42.66 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $18.62 Typical High $25.12 | Professional | 54 · Surgery only | $14.45 | $18.62 | $25.12 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $15.49 Median $19.95 Typical High $26.92 | Professional | 78 · Unplanned return to OR | $15.49 | $19.95 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $27.54 | Facility | None | $23.99 | $23.99 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $26.92 Typical High $38.02 | Professional | None | $16.60 | $26.92 | $38.02 |
Medica Setting Facility Modifier None Typical Low $12.30 Median $24.55 Typical High $263.03 | Facility | None | $12.30 | $24.55 | $263.03 |
Medica Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $33.11 | Professional | None | $16.22 | $28.18 | $33.11 |
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 $13.49 Median $23.44 Typical High $30.20 | Professional | None | $13.49 | $23.44 | $30.20 |
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 $6.17 Median $6.17 Typical High $7.59 | Facility | 52 · Reduced service | $6.17 | $6.17 | $7.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $3.09 | Facility | 53 · Discontinued | $2.45 | $2.45 | $3.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $2.29 | Facility | 55 · Aftercare only | $1.86 | $1.86 | $2.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.51 | Facility | 56 · Pre-op care only | $1.23 | $1.23 | $1.51 |
Where North Dakota sits
The same service costs 3.5 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· 9th of 51
$25.12
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.