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 $162.18 Median $223.87 Typical High $407.38 | Facility | None | $162.18 | $223.87 | $407.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $123.03 Typical High $165.96 | Facility | 54 · Surgery only | $120.23 | $123.03 | $165.96 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $114.82 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $112.20 | $114.82 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $245.47 | Professional | None | $144.54 | $181.97 | $245.47 |
BCBS North Dakota Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $2,238.72 | Facility | None | $416.87 | $741.31 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $562.34 | Professional | None | $302.00 | $407.38 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $363.08 Median $489.78 Typical High $676.08 | Professional | 22 · Increased work | $363.08 | $489.78 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $213.80 | $281.84 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Facility | None | $389.05 | $389.05 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $616.60 | Professional | None | $275.42 | $416.87 | $616.60 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $380.19 Typical High $1,698.24 | Facility | None | $162.18 | $380.19 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $1,230.27 | Professional | None | $229.09 | $407.38 | $1,230.27 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $436.52 | Professional | None | $169.82 | $302.00 | $436.52 |
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 $81.28 Median $81.28 Typical High $112.20 | Facility | 52 · Reduced service | $81.28 | $81.28 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $44.67 | Facility | 53 · Discontinued | $32.36 | $32.36 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $33.11 | Facility | 55 · Aftercare only | $23.99 | $24.55 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $22.39 | Facility | 56 · Pre-op care only | $16.22 | $16.22 | $22.39 |
Where North Dakota sits
The same service costs 4.6 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· 5th of 51
$372
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.