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 $169.82 Median $251.19 Typical High $257.04 | Facility | None | $169.82 | $251.19 | $257.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $190.55 | Facility | 54 · Surgery only | $128.82 | $128.82 | $190.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $120.23 | $120.23 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $263.03 | Professional | None | $154.88 | $218.78 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $602.56 | Professional | None | $288.40 | $426.58 | $602.56 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $512.86 Typical High $724.44 | Professional | 22 · Increased work | $346.74 | $512.86 | $724.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $302.00 Typical High $426.58 | Professional | 54 · Surgery only | $199.53 | $302.00 | $426.58 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $323.59 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $213.80 | $323.59 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Facility | None | $436.52 | $436.52 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $691.83 | Professional | None | $281.84 | $446.68 | $691.83 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $346.74 Typical High $758.58 | Facility | None | $169.82 | $346.74 | $758.58 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $1,258.93 | Professional | None | $257.04 | $467.74 | $1,258.93 |
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 $173.78 Median $323.59 Typical High $512.86 | Professional | None | $173.78 | $323.59 | $512.86 |
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 $85.11 Median $85.11 Typical High $128.82 | Facility | 52 · Reduced service | $85.11 | $85.11 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $51.29 | Facility | 53 · Discontinued | $33.88 | $33.88 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $38.90 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $25.70 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $25.70 |
Where North Dakota sits
The same service costs 3.4 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
$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.