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 $208.93 Median $295.12 Typical High $302.00 | Facility | None | $208.93 | $295.12 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $223.87 | Facility | 54 · Surgery only | $158.49 | $158.49 | $223.87 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $331.13 | Professional | None | $190.55 | $257.04 | $331.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $724.44 | Professional | None | $354.81 | $524.81 | $724.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $426.58 Median $616.60 Typical High $870.96 | Professional | 22 · Increased work | $426.58 | $616.60 | $870.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $363.08 Typical High $501.19 | Professional | 54 · Surgery only | $245.47 | $363.08 | $501.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $263.03 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Facility | None | $512.86 | $512.86 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $812.83 | Professional | None | $346.74 | $549.54 | $812.83 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $758.58 | Facility | None | $208.93 | $371.54 | $758.58 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $1,548.82 | Professional | None | $309.03 | $562.34 | $1,548.82 |
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 $398.11 Typical High $602.56 | Professional | None | $218.78 | $398.11 | $602.56 |
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 $104.71 Median $104.71 Typical High $151.36 | Facility | 52 · Reduced service | $104.71 | $104.71 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $60.26 | Facility | 53 · Discontinued | $41.69 | $41.69 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $44.67 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.20 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $30.20 |
Where North Dakota sits
The same service costs 3.9 times more in Alaska than in Texas. 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
$457
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.