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 $31.62 Median $70.79 Typical High $72.44 | Facility | None | $31.62 | $70.79 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $23.99 Median $23.99 Typical High $54.95 | Facility | 54 · Surgery only | $23.99 | $23.99 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $72.44 | Professional | None | $28.84 | $38.90 | $72.44 |
BCBS North Dakota Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $173.78 | Professional | None | $50.12 | $79.43 | $173.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $60.26 Median $95.50 Typical High $208.93 | Professional | 22 · Increased work | $60.26 | $95.50 | $208.93 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $54.95 Typical High $120.23 | Professional | 54 · Surgery only | $34.67 | $54.95 | $120.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $81.28 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $37.15 | $81.28 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Facility | None | $123.03 | $123.03 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $194.98 | Professional | None | $50.12 | $104.71 | $194.98 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $95.50 Typical High $263.03 | Facility | None | $31.62 | $95.50 | $263.03 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $251.19 | Professional | None | $74.13 | $134.90 | $251.19 |
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 $33.11 Median $67.61 Typical High $144.54 | Professional | None | $33.11 | $67.61 | $144.54 |
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 $15.85 Median $15.85 Typical High $36.31 | Facility | 52 · Reduced service | $15.85 | $15.85 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $14.45 | Facility | 53 · Discontinued | $6.31 | $6.31 | $14.45 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $10.96 | Facility | 55 · Aftercare only | $4.79 | $4.79 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $7.24 | Facility | 56 · Pre-op care only | $3.16 | $3.16 | $7.24 |
Where North Dakota sits
The same service costs 3.3 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· 20th 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.