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 $213.80 Median $316.23 Typical High $6,456.54 | Facility | None | $213.80 | $316.23 | $6,456.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $234.42 | Facility | 54 · Surgery only | $158.49 | $158.49 | $234.42 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $316.23 | Professional | None | $190.55 | $257.04 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $758.58 | Professional | None | $363.08 | $537.03 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $436.52 Median $645.65 Typical High $912.01 | Professional | 22 · Increased work | $436.52 | $645.65 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $524.81 | Professional | 54 · Surgery only | $251.19 | $380.19 | $524.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $851.14 | Professional | None | $371.54 | $575.44 | $851.14 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $371.54 Typical High $758.58 | Facility | None | $213.80 | $371.54 | $758.58 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $1,584.89 | Professional | None | $323.59 | $588.84 | $1,584.89 |
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 $218.78 Median $407.38 Typical High $630.96 | Professional | None | $218.78 | $407.38 | $630.96 |
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 $107.15 Median $107.15 Typical High $158.49 | Facility | 52 · Reduced service | $107.15 | $107.15 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $63.10 | Facility | 53 · Discontinued | $42.66 | $42.66 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $46.77 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $31.62 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $31.62 |
Where North Dakota sits
The same service costs 3.6 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· 7th of 51
$468
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.