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 $23.44 Median $74.13 Typical High $74.13 | Facility | None | $23.44 | $74.13 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $17.38 Median $17.38 Typical High $56.23 | Facility | 54 · Surgery only | $17.38 | $17.38 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $83.18 | Professional | None | $21.38 | $30.20 | $83.18 |
BCBS North Dakota Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $199.53 | Professional | None | $38.90 | $58.88 | $199.53 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $46.77 Median $70.79 Typical High $234.42 | Professional | 22 · Increased work | $46.77 | $70.79 | $234.42 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $87.10 Typical High $138.04 | Professional | 54 · Surgery only | $27.54 | $87.10 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $43.65 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $29.51 | $43.65 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $165.96 | Facility | None | $144.54 | $144.54 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $72.44 Typical High $229.09 | Professional | None | $35.48 | $72.44 | $229.09 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $74.13 Typical High $263.03 | Facility | None | $23.44 | $74.13 | $263.03 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $309.03 | Professional | None | $74.13 | $117.49 | $309.03 |
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 $23.99 Median $54.95 Typical High $125.89 | Professional | None | $23.99 | $54.95 | $125.89 |
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 $11.75 Median $11.75 Typical High $37.15 | Facility | 52 · Reduced service | $11.75 | $11.75 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $15.14 | Facility | 53 · Discontinued | $4.68 | $4.68 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $11.22 | Facility | 55 · Aftercare only | $3.47 | $3.47 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $7.41 | Facility | 56 · Pre-op care only | $2.34 | $2.34 | $7.41 |
Where North Dakota sits
The same service costs 3.4 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· 18th of 51
$74.13
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.