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 $169.82 Median $245.47 Typical High $245.47 | Facility | None | $169.82 | $245.47 | $245.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $186.21 | Facility | 54 · Surgery only | $128.82 | $128.82 | $186.21 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $120.23 | $120.23 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $245.47 | Professional | None | $162.18 | $223.87 | $245.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $575.44 | Professional | None | $275.42 | $416.87 | $575.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $331.13 Median $501.19 Typical High $691.83 | Professional | 22 · Increased work | $331.13 | $501.19 | $691.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $295.12 Typical High $407.38 | Professional | 54 · Surgery only | $194.98 | $295.12 | $407.38 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $316.23 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $208.93 | $316.23 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Facility | None | $426.58 | $426.58 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | None | $281.84 | $446.68 | $660.69 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $416.87 | Facility | None | $125.89 | $245.47 | $416.87 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $1,258.93 | Professional | None | $251.19 | $457.09 | $1,258.93 |
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 $177.83 Median $331.13 Typical High $489.78 | Professional | None | $177.83 | $331.13 | $489.78 |
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 $85.11 Median $85.11 Typical High $123.03 | Facility | 52 · Reduced service | $85.11 | $85.11 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $48.98 | Facility | 53 · Discontinued | $33.88 | $33.88 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $37.15 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $24.55 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $24.55 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$355
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.