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 $141.25 Median $208.93 Typical High $208.93 | Facility | None | $141.25 | $208.93 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $158.49 | Facility | 54 · Surgery only | $104.71 | $104.71 | $158.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $97.72 | $97.72 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $208.93 | Professional | None | $131.83 | $181.97 | $208.93 |
BCBS North Dakota Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $501.19 | Professional | None | $229.09 | $346.74 | $501.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $275.42 Median $416.87 Typical High $588.84 | Professional | 22 · Increased work | $275.42 | $416.87 | $588.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $346.74 | Professional | 54 · Surgery only | $158.49 | $245.47 | $346.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $263.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $169.82 | $263.03 | $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 $239.88 Median $371.54 Typical High $575.44 | Professional | None | $239.88 | $371.54 | $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 $213.80 Median $389.05 Typical High $1,023.29 | Professional | None | $213.80 | $389.05 | $1,023.29 |
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 $144.54 Median $269.15 Typical High $416.87 | Professional | None | $144.54 | $269.15 | $416.87 |
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 $70.79 Median $70.79 Typical High $104.71 | Facility | 52 · Reduced service | $70.79 | $70.79 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $41.69 | Facility | 53 · Discontinued | $28.18 | $28.18 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $31.62 | Facility | 55 · Aftercare only | $20.89 | $20.89 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $20.89 | Facility | 56 · Pre-op care only | $14.13 | $14.13 | $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· 7th of 51
$288
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.