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 $53.70 Median $66.07 Typical High $117.49 | Facility | None | $53.70 | $66.07 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $40.74 Median $41.69 Typical High $48.98 | Facility | 54 · Surgery only | $40.74 | $41.69 | $48.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $38.90 Typical High $45.71 | Facility | 78 · Unplanned return to OR | $38.02 | $38.90 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $100.00 | Professional | None | $51.29 | $66.07 | $100.00 |
BCBS North Dakota Setting Facility Modifier None Typical Low $74.13 Median $123.03 Typical High $363.08 | Facility | None | $74.13 | $123.03 | $363.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $162.18 | Professional | None | $95.50 | $123.03 | $162.18 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $114.82 Median $144.54 Typical High $194.98 | Professional | 22 · Increased work | $114.82 | $144.54 | $194.98 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $112.20 | Professional | 54 · Surgery only | $66.07 | $85.11 | $112.20 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $91.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $70.79 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Facility | None | $120.23 | $120.23 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $190.55 | Professional | None | $93.33 | $134.90 | $190.55 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $95.50 Typical High $263.03 | Facility | None | $53.70 | $95.50 | $263.03 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $169.82 | Professional | None | $66.07 | $120.23 | $169.82 |
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 $54.95 Median $100.00 Typical High $131.83 | Professional | None | $54.95 | $100.00 | $131.83 |
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 $26.92 Median $27.54 Typical High $33.11 | Facility | 52 · Reduced service | $26.92 | $27.54 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $11.22 Typical High $13.18 | Facility | 53 · Discontinued | $10.72 | $11.22 | $13.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $9.77 | Facility | 55 · Aftercare only | $8.13 | $8.32 | $9.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $6.61 | Facility | 56 · Pre-op care only | $5.37 | $5.50 | $6.61 |
Where North Dakota sits
The same service costs 4.2 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· 5th of 51
$117
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.