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 $67.61 Median $112.20 Typical High $199.53 | Facility | None | $67.61 | $112.20 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $50.12 Median $52.48 Typical High $85.11 | Facility | 54 · Surgery only | $50.12 | $52.48 | $85.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $48.98 Typical High $79.43 | Facility | 78 · Unplanned return to OR | $46.77 | $48.98 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $169.82 | Professional | None | $64.57 | $104.71 | $169.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $204.17 Median $275.42 Typical High $457.09 | Facility | None | $204.17 | $275.42 | $457.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Professional | None | $125.89 | $177.83 | $269.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $213.80 Typical High $323.59 | Professional | 22 · Increased work | $147.91 | $213.80 | $323.59 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $123.03 Typical High $190.55 | Professional | 54 · Surgery only | $87.10 | $123.03 | $190.55 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $131.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $93.33 | $131.83 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $229.09 | Facility | None | $199.53 | $199.53 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $316.23 | Professional | None | $125.89 | $194.98 | $316.23 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $125.89 Typical High $269.15 | Facility | None | $67.61 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $316.23 | Professional | None | $114.82 | $223.87 | $316.23 |
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 $69.18 Median $131.83 Typical High $223.87 | Professional | None | $69.18 | $131.83 | $223.87 |
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 $33.88 Median $34.67 Typical High $56.23 | Facility | 52 · Reduced service | $33.88 | $34.67 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $22.39 | Facility | 53 · Discontinued | $13.49 | $14.13 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $16.98 | Facility | 55 · Aftercare only | $10.00 | $10.47 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $11.22 | Facility | 56 · Pre-op care only | $6.76 | $7.08 | $11.22 |
Where North Dakota sits
The same service costs 3.9 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
$170
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.