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 $363.08 Median $457.09 Typical High $467.74 | Facility | None | $363.08 | $457.09 | $467.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $354.81 | Facility | 54 · Surgery only | $269.15 | $269.15 | $354.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $46.77 | Facility | 56 · Pre-op care only | $36.31 | $36.31 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $251.19 | $251.19 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $467.74 | Professional | None | $354.81 | $363.08 | $467.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $741.31 Median $954.99 Typical High $1,288.25 | Professional | 22 · Increased work | $741.31 | $954.99 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $426.58 | $562.34 | $758.58 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $107.15 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $107.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $457.09 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Facility | None | $794.33 | $794.33 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,230.27 | Professional | None | $602.56 | $891.25 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $363.08 Typical High $794.33 | Facility | None | $125.89 | $363.08 | $794.33 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $2,691.53 | Professional | None | $478.63 | $891.25 | $2,691.53 |
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 $371.54 Median $691.83 Typical High $954.99 | Professional | None | $371.54 | $691.83 | $954.99 |
3 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 $181.97 Median $181.97 Typical High $234.42 | Facility | 52 · Reduced service | $181.97 | $181.97 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $93.33 | Facility | 53 · Discontinued | $72.44 | $72.44 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $70.79 | Facility | 55 · Aftercare only | $54.95 | $54.95 | $70.79 |
Where North Dakota sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 7th of 51
$741
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.