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 $147.91 Median $257.04 Typical High $363.08 | Facility | None | $147.91 | $257.04 | $363.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $190.55 | Facility | 54 · Surgery only | $109.65 | $109.65 | $190.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $263.03 | Professional | None | $144.54 | $208.93 | $263.03 |
BCBS North Dakota Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $537.03 | Facility | None | $269.15 | $426.58 | $537.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $645.65 | Professional | None | $257.04 | $389.05 | $645.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $309.03 Median $457.09 Typical High $758.58 | Professional | 22 · Increased work | $309.03 | $457.09 | $758.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $446.68 | Professional | 54 · Surgery only | $181.97 | $269.15 | $446.68 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $524.81 | Facility | None | $457.09 | $457.09 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $724.44 | Professional | None | $257.04 | $446.68 | $724.44 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $436.52 | Facility | None | $125.89 | $251.19 | $436.52 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $1,071.52 | Professional | None | $257.04 | $467.74 | $1,071.52 |
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 $151.36 Median $281.84 Typical High $467.74 | Professional | None | $151.36 | $281.84 | $467.74 |
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 $74.13 Median $74.13 Typical High $125.89 | Facility | 52 · Reduced service | $74.13 | $74.13 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $51.29 | Facility | 53 · Discontinued | $29.51 | $29.51 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $38.02 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $25.70 | Facility | 56 · Pre-op care only | $14.79 | $14.79 | $25.70 |
Where North Dakota sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$316
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.