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 $107.15 Median $165.96 Typical High $165.96 | Facility | None | $107.15 | $165.96 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $123.03 | Facility | 54 · Surgery only | $79.43 | $79.43 | $123.03 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $114.82 | Facility | 78 · Unplanned return to OR | $74.13 | $74.13 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $165.96 | Professional | None | $102.33 | $138.04 | $165.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $398.11 | Professional | None | $177.83 | $269.15 | $398.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $213.80 Median $323.59 Typical High $478.63 | Professional | 22 · Increased work | $213.80 | $323.59 | $478.63 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $190.55 Typical High $275.42 | Professional | 54 · Surgery only | $123.03 | $190.55 | $275.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $204.17 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $131.83 | $204.17 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Facility | None | $295.12 | $295.12 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $457.09 | Professional | None | $177.83 | $281.84 | $457.09 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $165.96 Typical High $281.84 | Facility | None | $107.15 | $165.96 | $281.84 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $794.33 | Professional | None | $165.96 | $302.00 | $794.33 |
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 $109.65 Median $208.93 Typical High $323.59 | Professional | None | $109.65 | $208.93 | $323.59 |
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 $53.70 Median $53.70 Typical High $83.18 | Facility | 52 · Reduced service | $53.70 | $53.70 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $33.11 | Facility | 53 · Discontinued | $21.38 | $21.38 | $33.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $24.55 | Facility | 55 · Aftercare only | $15.85 | $15.85 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $16.60 | Facility | 56 · Pre-op care only | $10.72 | $10.72 | $16.60 |
Where North Dakota sits
The same service costs 3.5 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
$229
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.