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 $114.82 Median $169.82 Typical High $173.78 | Facility | None | $114.82 | $169.82 | $173.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $128.82 | Facility | 54 · Surgery only | $85.11 | $87.10 | $128.82 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $81.28 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $79.43 | $81.28 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $190.55 | Professional | None | $107.15 | $151.36 | $190.55 |
BCBS North Dakota Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $1,659.59 | Facility | None | $512.86 | $891.25 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $416.87 | Professional | None | $204.17 | $295.12 | $416.87 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $354.81 Typical High $501.19 | Professional | 22 · Increased work | $245.47 | $354.81 | $501.19 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $144.54 | $208.93 | $288.40 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $346.74 | Facility | None | $302.00 | $302.00 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $467.74 | Professional | None | $194.98 | $309.03 | $467.74 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $245.47 Typical High $758.58 | Facility | None | $114.82 | $245.47 | $758.58 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $870.96 | Professional | None | $162.18 | $281.84 | $870.96 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $331.13 | Professional | None | $117.49 | $213.80 | $331.13 |
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 $57.54 Median $57.54 Typical High $85.11 | Facility | 52 · Reduced service | $57.54 | $57.54 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $33.88 | Facility | 53 · Discontinued | $22.91 | $22.91 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $25.70 | Facility | 55 · Aftercare only | $16.98 | $17.38 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $16.98 | Facility | 56 · Pre-op care only | $11.48 | $11.48 | $16.98 |
Where North Dakota sits
The same service costs 3.8 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· 7th of 51
$257
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.