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 $323.59 Median $380.19 Typical High $389.05 | Facility | None | $323.59 | $380.19 | $389.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $295.12 | Facility | 54 · Surgery only | $239.88 | $239.88 | $295.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $389.05 | Professional | None | $302.00 | $323.59 | $389.05 |
BCBS North Dakota Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $977.24 | Professional | None | $562.34 | $707.95 | $977.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $676.08 Median $851.14 Typical High $1,174.90 | Professional | 22 · Increased work | $676.08 | $851.14 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $501.19 | $676.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,047.13 | Professional | None | $549.54 | $758.58 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $562.34 Typical High $2,511.89 | Facility | None | $323.59 | $562.34 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $724.44 Typical High $2,344.23 | Professional | None | $398.11 | $724.44 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $331.13 Median $602.56 Typical High $776.25 | Professional | None | $331.13 | $602.56 | $776.25 |
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 $162.18 Median $162.18 Typical High $194.98 | Facility | 52 · Reduced service | $162.18 | $162.18 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $77.62 | Facility | 53 · Discontinued | $64.57 | $64.57 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | 56 · Pre-op care only | $32.36 | $32.36 | $38.90 |
Where North Dakota sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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
$692
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.