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 $87.10 Median $141.25 Typical High $141.25 | Facility | None | $87.10 | $141.25 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $104.71 | Facility | 54 · Surgery only | $66.07 | $66.07 | $104.71 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $61.66 Typical High $97.72 | Facility | 78 · Unplanned return to OR | $61.66 | $61.66 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $141.25 | Professional | None | $81.28 | $120.23 | $141.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | None | $147.91 | $223.87 | $338.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $177.83 Median $288.40 Typical High $407.38 | Professional | 22 · Increased work | $177.83 | $288.40 | $407.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $104.71 | $158.49 | $234.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $281.84 | Facility | None | $245.47 | $245.47 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $389.05 | Professional | None | $147.91 | $239.88 | $389.05 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $263.03 | Facility | None | $87.10 | $141.25 | $263.03 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $645.65 | Professional | None | $141.25 | $263.03 | $645.65 |
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 $89.13 Median $169.82 Typical High $281.84 | Professional | None | $89.13 | $169.82 | $281.84 |
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 $43.65 Median $43.65 Typical High $70.79 | Facility | 52 · Reduced service | $43.65 | $43.65 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $28.18 | Facility | 53 · Discontinued | $17.38 | $17.38 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $20.89 | Facility | 55 · Aftercare only | $13.18 | $13.18 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $14.13 | Facility | 56 · Pre-op care only | $8.71 | $8.71 | $14.13 |
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· 8th of 51
$191
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.