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 $181.97 Median $208.93 Typical High $851.14 | Facility | None | $181.97 | $208.93 | $851.14 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $158.49 | Facility | 54 · Surgery only | $138.04 | $138.04 | $158.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $281.84 | Professional | None | $144.54 | $181.97 | $281.84 |
BCBS North Dakota Setting Facility Modifier None Typical Low $263.03 Median $346.74 Typical High $1,548.82 | Facility | None | $263.03 | $346.74 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $537.03 | Professional | None | $338.84 | $416.87 | $537.03 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $501.19 Typical High $645.65 | Professional | 22 · Increased work | $398.11 | $501.19 | $645.65 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $295.12 Typical High $371.54 | Professional | 54 · Surgery only | $234.42 | $295.12 | $371.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $316.23 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $251.19 | $316.23 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Facility | None | $371.54 | $371.54 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $588.84 | Professional | None | $309.03 | $416.87 | $588.84 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $389.05 | Facility | None | $134.90 | $208.93 | $389.05 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $1,380.38 | Professional | None | $213.80 | $389.05 | $1,380.38 |
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 $186.21 Median $338.84 Typical High $407.38 | Professional | None | $186.21 | $338.84 | $407.38 |
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 $91.20 Median $91.20 Typical High $104.71 | Facility | 52 · Reduced service | $91.20 | $91.20 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $41.69 | Facility | 53 · Discontinued | $36.31 | $36.31 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $31.62 | Facility | 55 · Aftercare only | $27.54 | $27.54 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.89 | Facility | 56 · Pre-op care only | $18.20 | $18.20 | $20.89 |
Where North Dakota sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 6th of 51
$380
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.