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 $60.26 Typical High $724.44 | Facility | None | $50.12 | $60.26 | $724.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $44.67 | Facility | 54 · Surgery only | $37.15 | $37.15 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $74.13 | Professional | None | $44.67 | $54.95 | $74.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $144.54 | Professional | None | $85.11 | $109.65 | $144.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $102.33 Median $131.83 Typical High $173.78 | Professional | 22 · Increased work | $102.33 | $131.83 | $173.78 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $77.62 | $102.33 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $83.18 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $64.57 | $83.18 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Facility | None | $102.33 | $102.33 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $162.18 | Professional | None | $72.44 | $107.15 | $162.18 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $501.19 | Facility | None | $50.12 | $125.89 | $501.19 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $128.82 | Professional | None | $61.66 | $109.65 | $128.82 |
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 $51.29 Median $91.20 Typical High $120.23 | Professional | None | $51.29 | $91.20 | $120.23 |
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 $24.55 Median $24.55 Typical High $29.51 | Facility | 52 · Reduced service | $24.55 | $24.55 | $29.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $12.02 | Facility | 53 · Discontinued | $10.00 | $10.00 | $12.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $8.91 | Facility | 55 · Aftercare only | $7.41 | $7.41 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $6.03 | Facility | 56 · Pre-op care only | $5.01 | $5.01 | $6.03 |
Where North Dakota sits
The same service costs 4.8 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· 8th of 51
$105
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.