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 $169.82 Median $275.42 Typical High $501.19 | Facility | None | $169.82 | $275.42 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $204.17 | Facility | 54 · Surgery only | $128.82 | $128.82 | $204.17 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $120.23 | $120.23 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $281.84 | Professional | None | $162.18 | $229.09 | $281.84 |
BCBS North Dakota Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $645.65 | Facility | None | $269.15 | $457.09 | $645.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $691.83 | Professional | None | $295.12 | $436.52 | $691.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $354.81 Median $524.81 Typical High $831.76 | Professional | 22 · Increased work | $354.81 | $524.81 | $831.76 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $208.93 | $309.03 | $478.63 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $331.13 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $223.87 | $331.13 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Facility | None | $489.78 | $489.78 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $758.58 | Professional | None | $281.84 | $457.09 | $758.58 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $467.74 | Facility | None | $125.89 | $251.19 | $467.74 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $1,258.93 | Professional | None | $281.84 | $501.19 | $1,258.93 |
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 $173.78 Median $323.59 Typical High $512.86 | Professional | None | $173.78 | $323.59 | $512.86 |
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 $85.11 Median $85.11 Typical High $138.04 | Facility | 52 · Reduced service | $85.11 | $85.11 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $54.95 | Facility | 53 · Discontinued | $33.88 | $33.88 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $40.74 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $27.54 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $27.54 |
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· 8th of 51
$363
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.