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 $50.12 Median $77.62 Typical High $79.43 | Facility | None | $50.12 | $77.62 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $58.88 | Facility | 54 · Surgery only | $38.02 | $38.02 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $138.04 | Professional | None | $50.12 | $69.18 | $138.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $190.55 | Professional | None | $89.13 | $131.83 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $107.15 Median $158.49 Typical High $229.09 | Professional | 22 · Increased work | $107.15 | $158.49 | $229.09 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $199.53 Typical High $288.40 | Professional | 50 · Both sides | $131.83 | $199.53 | $288.40 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $93.33 Typical High $134.90 | Professional | 54 · Surgery only | $61.66 | $93.33 | $134.90 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $100.00 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $66.07 | $100.00 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Facility | None | $138.04 | $138.04 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $245.47 | Professional | None | $85.11 | $131.83 | $245.47 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $263.03 | Facility | None | $50.12 | $100.00 | $263.03 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $177.83 | Professional | None | $81.28 | $162.18 | $177.83 |
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 $52.48 Median $102.33 Typical High $177.83 | Professional | None | $52.48 | $102.33 | $177.83 |
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 $25.12 Median $25.12 Typical High $39.81 | Facility | 52 · Reduced service | $25.12 | $25.12 | $39.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $15.85 | Facility | 53 · Discontinued | $10.23 | $10.23 | $15.85 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $11.75 | Facility | 55 · Aftercare only | $7.59 | $7.59 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $7.94 | Facility | 56 · Pre-op care only | $5.13 | $5.13 | $7.94 |
Where North Dakota sits
The same service costs 3.2 times more in Wisconsin 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· 15th of 51
$115
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.