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 $251.19 Median $389.05 Typical High $407.38 | Facility | None | $251.19 | $389.05 | $407.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $302.00 | Facility | 54 · Surgery only | $186.21 | $186.21 | $302.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $281.84 | Facility | 78 · Unplanned return to OR | $173.78 | $173.78 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $436.52 | Professional | None | $239.88 | $346.74 | $436.52 |
BCBS North Dakota Setting Facility Modifier None Typical Low $380.19 Median $758.58 Typical High $933.25 | Facility | None | $380.19 | $758.58 | $933.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $954.99 | Professional | None | $416.87 | $630.96 | $954.99 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $501.19 Median $758.58 Typical High $1,148.15 | Professional | 22 · Increased work | $501.19 | $758.58 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $295.12 | $436.52 | $660.69 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $316.23 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Facility | None | $691.83 | $691.83 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,071.52 | Professional | None | $407.38 | $660.69 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $707.95 | Facility | None | $181.97 | $269.15 | $707.95 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $1,819.70 | Professional | None | $407.38 | $741.31 | $1,819.70 |
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 $257.04 Median $478.63 Typical High $794.33 | Professional | None | $257.04 | $478.63 | $794.33 |
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 $125.89 Median $125.89 Typical High $204.17 | Facility | 52 · Reduced service | $125.89 | $125.89 | $204.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $81.28 | Facility | 53 · Discontinued | $50.12 | $50.12 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $60.26 | Facility | 55 · Aftercare only | $37.15 | $37.15 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $40.74 | Facility | 56 · Pre-op care only | $25.12 | $25.12 | $40.74 |
Where North Dakota sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$513
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.