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 $190.55 Median $295.12 Typical High $302.00 | Facility | None | $190.55 | $295.12 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $223.87 | Facility | 54 · Surgery only | $144.54 | $144.54 | $223.87 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $134.90 | $134.90 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $302.00 | Professional | None | $186.21 | $190.55 | $302.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $707.95 | Professional | None | $346.74 | $478.63 | $707.95 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $416.87 Median $575.44 Typical High $851.14 | Professional | 22 · Increased work | $416.87 | $575.44 | $851.14 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $501.19 | Professional | 54 · Surgery only | $245.47 | $338.84 | $501.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $263.03 | $363.08 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Facility | None | $501.19 | $501.19 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $776.25 | Professional | None | $309.03 | $501.19 | $776.25 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $1,096.48 | Facility | None | $190.55 | $338.84 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $1,412.54 | Professional | None | $302.00 | $524.81 | $1,412.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $562.34 | Professional | None | $199.53 | $346.74 | $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 $95.50 Median $95.50 Typical High $147.91 | Facility | 52 · Reduced service | $95.50 | $95.50 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $60.26 | Facility | 53 · Discontinued | $38.02 | $38.02 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $44.67 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $30.20 | Facility | 56 · Pre-op care only | $19.05 | $19.05 | $30.20 |
Where North Dakota sits
The same service costs 3.5 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· 8th of 51
$447
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.