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 $208.93 Median $363.08 Typical High $524.81 | Facility | None | $208.93 | $363.08 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $398.11 | Facility | 54 · Surgery only | $154.88 | $154.88 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $524.81 | Professional | None | $204.17 | $208.93 | $524.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $758.58 | Professional | None | $316.23 | $467.74 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $380.19 Median $562.34 Typical High $912.01 | Professional | 22 · Increased work | $380.19 | $562.34 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $331.13 Typical High $537.03 | Professional | 54 · Surgery only | $218.78 | $331.13 | $537.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $630.96 | Facility | None | $537.03 | $537.03 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $436.52 | Professional | None | $199.53 | $346.74 | $436.52 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $831.76 | Facility | None | $134.90 | $263.03 | $831.76 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,148.15 | Professional | None | $501.19 | $831.76 | $1,148.15 |
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 $213.80 Median $489.78 Typical High $954.99 | Professional | None | $213.80 | $489.78 | $954.99 |
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 $102.33 Median $102.33 Typical High $263.03 | Facility | 52 · Reduced service | $102.33 | $102.33 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $104.71 | Facility | 53 · Discontinued | $41.69 | $41.69 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $79.43 | Facility | 55 · Aftercare only | $30.90 | $30.90 | $79.43 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $52.48 | Facility | 56 · Pre-op care only | $20.42 | $20.42 | $52.48 |
Where North Dakota sits
The same service costs 2.8 times more in Wisconsin 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· 13th of 51
$437
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.