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 $120.23 Median $190.55 Typical High $190.55 | Facility | None | $120.23 | $190.55 | $190.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $141.25 | Facility | 54 · Surgery only | $91.20 | $93.33 | $141.25 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $87.10 Typical High $131.83 | Facility | 78 · Unplanned return to OR | $85.11 | $87.10 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $204.17 | Professional | None | $112.20 | $158.49 | $204.17 |
BCBS North Dakota Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $467.74 | Professional | None | $234.42 | $323.59 | $467.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $281.84 Median $389.05 Typical High $562.34 | Professional | 22 · Increased work | $281.84 | $389.05 | $562.34 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $478.63 Typical High $691.83 | Professional | 50 · Both sides | $354.81 | $478.63 | $691.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $223.87 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $223.87 | $323.59 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $239.88 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $177.83 | $239.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $467.74 | Professional | None | $186.21 | $309.03 | $467.74 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $213.80 Typical High $660.69 | Facility | None | $120.23 | $213.80 | $660.69 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $407.38 | Professional | None | $190.55 | $346.74 | $407.38 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $371.54 | Professional | None | $125.89 | $223.87 | $371.54 |
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 $60.26 Median $61.66 Typical High $93.33 | Facility | 52 · Reduced service | $60.26 | $61.66 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $38.02 | Facility | 53 · Discontinued | $23.99 | $25.12 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $28.18 | Facility | 55 · Aftercare only | $18.20 | $18.62 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $19.05 | Facility | 56 · Pre-op care only | $12.02 | $12.30 | $19.05 |
Where North Dakota sits
The same service costs 4.1 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· 9th of 51
$275
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.