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 $218.78 Median $380.19 Typical High $724.44 | Facility | None | $218.78 | $380.19 | $724.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $281.84 | Facility | 54 · Surgery only | $165.96 | $165.96 | $281.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $154.88 | $154.88 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $380.19 | Professional | None | $213.80 | $223.87 | $380.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $954.99 | Professional | None | $389.05 | $588.84 | $954.99 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $707.95 Typical High $1,148.15 | Professional | 22 · Increased work | $467.74 | $707.95 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $407.38 Typical High $660.69 | Professional | 54 · Surgery only | $275.42 | $407.38 | $660.69 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $436.52 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $295.12 | $436.52 | $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 $363.08 Median $588.84 Typical High $1,047.13 | Professional | None | $363.08 | $588.84 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $269.15 Typical High $660.69 | Facility | None | $134.90 | $269.15 | $660.69 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $1,621.81 | Professional | None | $389.05 | $676.08 | $1,621.81 |
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 $229.09 Median $416.87 Typical High $724.44 | Professional | None | $229.09 | $416.87 | $724.44 |
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 $109.65 Median $109.65 Typical High $190.55 | Facility | 52 · Reduced service | $109.65 | $109.65 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $75.86 | Facility | 53 · Discontinued | $43.65 | $43.65 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $56.23 | Facility | 55 · Aftercare only | $33.11 | $33.11 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $38.02 | Facility | 56 · Pre-op care only | $21.88 | $21.88 | $38.02 |
Where North Dakota sits
The same service costs 3.5 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
$479
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.