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 $131.83 Median $208.93 Typical High $208.93 | Facility | None | $131.83 | $208.93 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $154.88 | Facility | 54 · Surgery only | $100.00 | $100.00 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $144.54 | Facility | 78 · Unplanned return to OR | $93.33 | $93.33 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | None | $120.23 | $173.78 | $208.93 |
BCBS North Dakota Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $489.78 | Professional | None | $218.78 | $331.13 | $489.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $263.03 Median $398.11 Typical High $588.84 | Professional | 22 · Increased work | $263.03 | $398.11 | $588.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $234.42 Typical High $346.74 | Professional | 54 · Surgery only | $151.36 | $234.42 | $346.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $251.19 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $162.18 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $575.44 | Professional | None | $218.78 | $354.81 | $575.44 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $354.81 | Facility | None | $125.89 | $208.93 | $354.81 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $977.24 | Professional | None | $208.93 | $380.19 | $977.24 |
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 $138.04 Median $257.04 Typical High $407.38 | Professional | None | $138.04 | $257.04 | $407.38 |
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 $66.07 Median $66.07 Typical High $104.71 | Facility | 52 · Reduced service | $66.07 | $66.07 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $41.69 | Facility | 53 · Discontinued | $26.92 | $26.92 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $30.90 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $20.89 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $20.89 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 9th of 51
$275
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.