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 $48.98 Median $52.48 Typical High $52.48 | Facility | None | $48.98 | $52.48 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $38.90 | Facility | 54 · Surgery only | $37.15 | $37.15 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $34.67 Typical High $36.31 | Facility | 78 · Unplanned return to OR | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $52.48 | Professional | None | $42.66 | $48.98 | $52.48 |
BCBS North Dakota Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $128.82 | Professional | None | $83.18 | $104.71 | $128.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $100.00 Median $125.89 Typical High $154.88 | Professional | 22 · Increased work | $100.00 | $125.89 | $154.88 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $74.13 | $89.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $79.43 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $61.66 | $79.43 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $104.71 | Facility | None | $91.20 | $91.20 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $151.36 | Professional | None | $81.28 | $109.65 | $151.36 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $263.03 | Facility | None | $48.98 | $83.18 | $263.03 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $363.08 | Professional | None | $53.70 | $95.50 | $363.08 |
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 $51.29 Median $89.13 Typical High $102.33 | Professional | None | $51.29 | $89.13 | $102.33 |
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 $24.55 Median $24.55 Typical High $26.30 | Facility | 52 · Reduced service | $24.55 | $24.55 | $26.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.47 | Facility | 53 · Discontinued | $9.77 | $9.77 | $10.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.94 | Facility | 55 · Aftercare only | $7.41 | $7.41 | $7.94 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.25 | Facility | 56 · Pre-op care only | $4.90 | $4.90 | $5.25 |
Where North Dakota sits
The same service costs 4.6 times more in Alaska than in New York. 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· 6th of 51
$97.72
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.