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 $112.20 Median $177.83 Typical High $177.83 | Facility | None | $112.20 | $177.83 | $177.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $134.90 | Facility | 54 · Surgery only | $85.11 | $85.11 | $134.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $79.43 | $79.43 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $194.98 | Professional | None | $107.15 | $151.36 | $194.98 |
BCBS North Dakota Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $426.58 | Professional | None | $186.21 | $281.84 | $426.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $223.87 Median $338.84 Typical High $501.19 | Professional | 22 · Increased work | $223.87 | $338.84 | $501.19 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $128.82 | $199.53 | $295.12 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $213.80 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $138.04 | $213.80 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Facility | None | $316.23 | $316.23 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $489.78 | Professional | None | $186.21 | $302.00 | $489.78 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $302.00 | Facility | None | $112.20 | $177.83 | $302.00 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $831.76 | Professional | None | $181.97 | $346.74 | $831.76 |
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 $114.82 Median $218.78 Typical High $346.74 | Professional | None | $114.82 | $218.78 | $346.74 |
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 $56.23 Median $56.23 Typical High $89.13 | Facility | 52 · Reduced service | $56.23 | $56.23 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $35.48 | Facility | 53 · Discontinued | $22.39 | $22.39 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $26.92 | Facility | 55 · Aftercare only | $16.98 | $16.98 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $17.78 | Facility | 56 · Pre-op care only | $11.22 | $11.22 | $17.78 |
Where North Dakota sits
The same service costs 3.4 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
$245
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.