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 $295.12 Median $338.84 Typical High $389.05 | Facility | None | $295.12 | $338.84 | $389.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $295.12 | Facility | 54 · Surgery only | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $389.05 | Professional | None | $251.19 | $323.59 | $389.05 |
BCBS North Dakota Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $977.24 | Professional | None | $549.54 | $707.95 | $977.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $660.69 Median $851.14 Typical High $1,174.90 | Professional | 22 · Increased work | $660.69 | $851.14 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $380.19 | $501.19 | $691.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $537.03 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $407.38 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $741.31 | Facility | None | $645.65 | $645.65 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,148.15 | Professional | None | $416.87 | $691.83 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $660.69 | Facility | None | $125.89 | $295.12 | $660.69 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $724.44 Typical High $851.14 | Professional | None | $416.87 | $724.44 | $851.14 |
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 $323.59 Median $575.44 Typical High $794.33 | Professional | None | $323.59 | $575.44 | $794.33 |
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 $147.91 Median $147.91 Typical High $194.98 | Facility | 52 · Reduced service | $147.91 | $147.91 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $77.62 | Facility | 53 · Discontinued | $58.88 | $58.88 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $58.88 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $38.90 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $38.90 |
Where North Dakota sits
The same service costs 2.9 times more in Alaska 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· 7th of 51
$646
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.