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 $109.65 Median $162.18 Typical High $2,187.76 | Facility | None | $109.65 | $162.18 | $2,187.76 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $120.23 | Facility | 54 · Surgery only | $81.28 | $81.28 | $120.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $112.20 | Facility | 78 · Unplanned return to OR | $75.86 | $75.86 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $162.18 | Professional | None | $100.00 | $131.83 | $162.18 |
BCBS North Dakota Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,995.26 | Facility | None | $707.95 | $912.01 | $1,995.26 |
BCBS North Dakota Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $389.05 | Professional | None | $194.98 | $281.84 | $389.05 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $234.42 Median $338.84 Typical High $467.74 | Professional | 22 · Increased work | $234.42 | $338.84 | $467.74 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $138.04 | $194.98 | $269.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $208.93 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $147.91 | $208.93 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $323.59 | Facility | None | $281.84 | $281.84 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $436.52 | Professional | None | $194.98 | $281.84 | $436.52 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $229.09 Typical High $758.58 | Facility | None | $109.65 | $229.09 | $758.58 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $812.83 | Professional | None | $162.18 | $295.12 | $812.83 |
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 $112.20 Median $208.93 Typical High $309.03 | Professional | None | $112.20 | $208.93 | $309.03 |
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 $54.95 Median $54.95 Typical High $79.43 | Facility | 52 · Reduced service | $54.95 | $54.95 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $32.36 | Facility | 53 · Discontinued | $21.88 | $21.88 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $23.99 | Facility | 55 · Aftercare only | $16.60 | $16.60 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $16.22 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $16.22 |
Where North Dakota sits
The same service costs 3.5 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· 5th of 51
$251
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.