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 $223.87 Median $281.84 Typical High $281.84 | Facility | None | $223.87 | $281.84 | $281.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $213.80 | Facility | 54 · Surgery only | $169.82 | $169.82 | $213.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $281.84 | Professional | None | $204.17 | $229.09 | $281.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $707.95 | Professional | None | $398.11 | $512.86 | $707.95 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $478.63 Median $616.60 Typical High $831.76 | Professional | 22 · Increased work | $478.63 | $616.60 | $831.76 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $489.78 | Professional | 54 · Surgery only | $281.84 | $354.81 | $489.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $380.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $302.00 | $380.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Facility | None | $489.78 | $489.78 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $776.25 | Professional | None | $371.54 | $549.54 | $776.25 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $776.25 | Facility | None | $223.87 | $407.38 | $776.25 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $1,698.24 | Professional | None | $295.12 | $524.81 | $1,698.24 |
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 $234.42 Median $426.58 Typical High $562.34 | Professional | None | $234.42 | $426.58 | $562.34 |
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 $112.20 Median $112.20 Typical High $141.25 | Facility | 52 · Reduced service | $112.20 | $112.20 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $56.23 | Facility | 53 · Discontinued | $44.67 | $44.67 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $42.66 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $28.18 | Facility | 56 · Pre-op care only | $22.39 | $22.39 | $28.18 |
Where North Dakota sits
The same service costs 3.9 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· 6th of 51
$479
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.