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 $245.47 Median $389.05 Typical High $1,202.26 | Facility | None | $245.47 | $389.05 | $1,202.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $295.12 | Facility | 54 · Surgery only | $186.21 | $186.21 | $295.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $173.78 | $173.78 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $416.87 | Professional | None | $234.42 | $323.59 | $416.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $933.25 | Professional | None | $407.38 | $616.60 | $933.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $489.78 Median $741.31 Typical High $1,122.02 | Professional | 22 · Increased work | $489.78 | $741.31 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $426.58 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $426.58 | $660.69 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $457.09 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $302.00 | $457.09 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $776.25 | Facility | None | $676.08 | $676.08 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,047.13 | Professional | None | $398.11 | $645.65 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $691.83 | Facility | None | $181.97 | $269.15 | $691.83 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $724.44 Typical High $1,778.28 | Professional | None | $398.11 | $724.44 | $1,778.28 |
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 $251.19 Median $467.74 Typical High $776.25 | Professional | None | $251.19 | $467.74 | $776.25 |
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 $123.03 Median $123.03 Typical High $194.98 | Facility | 52 · Reduced service | $123.03 | $123.03 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $79.43 | Facility | 53 · Discontinued | $48.98 | $48.98 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $58.88 | Facility | 55 · Aftercare only | $37.15 | $37.15 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $38.90 | Facility | 56 · Pre-op care only | $24.55 | $24.55 | $38.90 |
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· 9th of 51
$501
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.