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 $37.15 Median $85.11 Typical High $549.54 | Facility | None | $37.15 | $85.11 | $549.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $27.54 Median $27.54 Typical High $64.57 | Facility | 54 · Surgery only | $27.54 | $27.54 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $57.54 Typical High $85.11 | Professional | None | $32.36 | $57.54 | $85.11 |
BCBS North Dakota Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $218.78 | Professional | None | $70.79 | $104.71 | $218.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $85.11 Median $125.89 Typical High $263.03 | Professional | 22 · Increased work | $85.11 | $125.89 | $263.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $74.13 Typical High $154.88 | Professional | 54 · Surgery only | $48.98 | $74.13 | $154.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $79.43 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $52.48 | $79.43 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Facility | None | $147.91 | $147.91 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $125.89 Typical High $234.42 | Professional | None | $61.66 | $125.89 | $234.42 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $120.23 Typical High $269.15 | Facility | None | $37.15 | $120.23 | $269.15 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $331.13 | Professional | None | $87.10 | $147.91 | $331.13 |
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 $38.90 Median $74.13 Typical High $158.49 | Professional | None | $38.90 | $74.13 | $158.49 |
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 $18.62 Median $18.62 Typical High $42.66 | Facility | 52 · Reduced service | $18.62 | $18.62 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $16.98 | Facility | 53 · Discontinued | $7.41 | $7.41 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $12.88 | Facility | 55 · Aftercare only | $5.50 | $5.50 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $8.51 | Facility | 56 · Pre-op care only | $3.72 | $3.72 | $8.51 |
Where North Dakota sits
The same service costs 3.7 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· 13th of 51
$95.50
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.