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 $354.81 Median $398.11 Typical High $398.11 | Facility | None | $354.81 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $302.00 | Facility | 54 · Surgery only | $269.15 | $269.15 | $302.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $39.81 | Facility | 56 · Pre-op care only | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $537.03 | Professional | None | $354.81 | $389.05 | $537.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,047.13 | Professional | None | $660.69 | $831.76 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $1,000.00 Typical High $1,258.93 | Professional | 22 · Increased work | $794.33 | $1,000.00 | $1,258.93 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $588.84 | $724.44 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $83.18 Typical High $104.71 | Professional | 56 · Pre-op care only | $66.07 | $83.18 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $812.83 | Facility | None | $707.95 | $707.95 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,202.26 | Professional | None | $524.81 | $794.33 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $676.08 Typical High $2,754.23 | Facility | None | $354.81 | $676.08 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $870.96 | Professional | None | $426.58 | $707.95 | $870.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $812.83 | Professional | None | $389.05 | $676.08 | $812.83 |
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 $177.83 Median $177.83 Typical High $199.53 | Facility | 52 · Reduced service | $177.83 | $177.83 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $79.43 | Facility | 53 · Discontinued | $72.44 | $72.44 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | 55 · Aftercare only | $53.70 | $53.70 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $281.84 | Facility | 78 · Unplanned return to OR | $251.19 | $251.19 | $281.84 |
Where North Dakota sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 8th of 51
$741
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.