How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $8,511.38 Median $8,511.38 Typical High $8,511.38 | Facility | None | $8,511.38 | $8,511.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $9,120.11 | Professional | None | $8,511.38 | $8,511.38 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,258.93 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $912.01 |
BCBS North Dakota Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $6,918.31 Median $8,709.64 Typical High $10,232.93 | Professional | None | $6,918.31 | $8,709.64 | $10,232.93 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $8,317.64 Median $10,471.29 Typical High $12,302.69 | Professional | 22 · Increased work | $8,317.64 | $10,471.29 | $12,302.69 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $1,380.38 Median $1,737.80 Typical High $2,041.74 | Professional | 55 · Aftercare only | $1,380.38 | $1,737.80 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $870.96 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $691.83 | $870.96 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $8,912.51 | Professional | None | $446.68 | $562.34 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $8,128.31 Typical High $24,547.09 | Facility | None | $436.52 | $8,128.31 | $24,547.09 |
Medica Setting Professional Modifier None Typical Low $8,511.38 Median $9,332.54 Typical High $37,153.52 | Professional | None | $8,511.38 | $9,332.54 | $37,153.52 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $10,964.78 | Professional | None | $8,709.64 | $9,332.54 | $10,964.78 |
2 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 Professional Modifier 52 · Reduced service Typical Low $4,265.80 Median $4,265.80 Typical High $4,570.88 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,698.24 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,698.24 | $1,698.24 | $1,819.70 |
Where North Dakota sits
The same service costs 26.3 times more in Alaska than in Montana. 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· 39th of 51
$8,710
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.