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 $70.79 Median $97.72 Typical High $97.72 | Facility | None | $70.79 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $72.44 | Facility | 54 · Surgery only | $52.48 | $52.48 | $72.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $48.98 Typical High $67.61 | Facility | 78 · Unplanned return to OR | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $100.00 | Professional | None | $64.57 | $81.28 | $100.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $234.42 | Professional | None | $117.49 | $169.82 | $234.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $141.25 Median $204.17 Typical High $281.84 | Professional | 22 · Increased work | $141.25 | $204.17 | $281.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $83.18 | $120.23 | $165.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $128.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $89.13 | $128.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $199.53 | Facility | None | $173.78 | $173.78 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $275.42 | Professional | None | $120.23 | $177.83 | $275.42 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $123.03 Typical High $263.03 | Facility | None | $70.79 | $123.03 | $263.03 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $524.81 | Professional | None | $100.00 | $177.83 | $524.81 |
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 $72.44 Median $131.83 Typical High $190.55 | Professional | None | $72.44 | $131.83 | $190.55 |
2 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 $35.48 Median $35.48 Typical High $48.98 | Facility | 52 · Reduced service | $35.48 | $35.48 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $19.50 | Facility | 53 · Discontinued | $14.13 | $14.13 | $19.50 |
Where North Dakota sits
The same service costs 3.8 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· 7th of 51
$151
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.