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 $93.33 Median $123.03 Typical High $125.89 | Facility | None | $93.33 | $123.03 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $93.33 | Facility | 54 · Surgery only | $70.79 | $70.79 | $93.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $66.07 Typical High $87.10 | Facility | 78 · Unplanned return to OR | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $125.89 | Professional | None | $91.20 | $114.82 | $125.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $295.12 | Professional | None | $154.88 | $213.80 | $295.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $186.21 Median $257.04 Typical High $354.81 | Professional | 22 · Increased work | $186.21 | $257.04 | $354.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $107.15 | $147.91 | $204.17 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $158.49 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $114.82 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Facility | None | $213.80 | $213.80 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $338.84 | Professional | None | $162.18 | $229.09 | $338.84 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $269.15 | Facility | None | $93.33 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $691.83 | Professional | None | $125.89 | $239.88 | $691.83 |
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 $95.50 Median $186.21 Typical High $257.04 | Professional | None | $95.50 | $186.21 | $257.04 |
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 $46.77 Median $46.77 Typical High $61.66 | Facility | 52 · Reduced service | $46.77 | $46.77 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $25.12 | Facility | 53 · Discontinued | $18.62 | $18.62 | $25.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $18.62 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $12.59 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $12.59 |
Where North Dakota sits
The same service costs 3.8 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· 7th of 51
$195
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.