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 $93.33 Median $169.82 Typical High $169.82 | Facility | None | $93.33 | $169.82 | $169.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $72.44 Typical High $128.82 | Facility | 54 · Surgery only | $70.79 | $72.44 | $128.82 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $67.61 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $66.07 | $67.61 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $169.82 | Professional | None | $64.57 | $117.49 | $169.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $398.11 | Professional | None | $177.83 | $251.19 | $398.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $213.80 Median $295.12 Typical High $478.63 | Professional | 22 · Increased work | $213.80 | $295.12 | $478.63 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $275.42 | Professional | 54 · Surgery only | $123.03 | $173.78 | $275.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $338.84 | Facility | None | $288.40 | $288.40 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $457.09 | Professional | None | $158.49 | $257.04 | $457.09 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $169.82 Typical High $281.84 | Facility | None | $93.33 | $169.82 | $281.84 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $707.95 | Professional | None | $173.78 | $316.23 | $707.95 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $338.84 | Professional | None | $95.50 | $186.21 | $338.84 |
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 $46.77 Median $47.86 Typical High $85.11 | Facility | 52 · Reduced service | $46.77 | $47.86 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $34.67 | Facility | 53 · Discontinued | $18.62 | $19.05 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.45 Typical High $25.70 | Facility | 55 · Aftercare only | $14.13 | $14.45 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $16.98 | Facility | 56 · Pre-op care only | $9.33 | $9.55 | $16.98 |
Where North Dakota sits
The same service costs 4.5 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· 10th of 51
$219
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.