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 $213.80 Median $371.54 Typical High $380.19 | Facility | None | $213.80 | $371.54 | $380.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $281.84 | Facility | 54 · Surgery only | $158.49 | $158.49 | $281.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $151.36 | $151.36 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | None | $199.53 | $288.40 | $380.19 |
BCBS North Dakota Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
BCBS North Dakota Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $933.25 | Professional | None | $380.19 | $562.34 | $933.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $676.08 Typical High $1,122.02 | Professional | 22 · Increased work | $457.09 | $676.08 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $398.11 Typical High $660.69 | Professional | 54 · Surgery only | $269.15 | $398.11 | $660.69 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $426.58 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $288.40 | $426.58 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $1,047.13 | Professional | None | $354.81 | $645.65 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $645.65 | Facility | None | $134.90 | $263.03 | $645.65 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $1,584.89 | Professional | None | $380.19 | $676.08 | $1,584.89 |
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 $223.87 Median $407.38 Typical High $707.95 | Professional | None | $223.87 | $407.38 | $707.95 |
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 $107.15 Median $107.15 Typical High $186.21 | Facility | 52 · Reduced service | $107.15 | $107.15 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $74.13 | Facility | 53 · Discontinued | $42.66 | $42.66 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $56.23 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $37.15 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $37.15 |
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· 9th 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.