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 $67.61 Median $141.25 Typical High $154.88 | Facility | None | $67.61 | $141.25 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $114.82 | Facility | 54 · Surgery only | $51.29 | $51.29 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $154.88 | Professional | None | $63.10 | $89.13 | $154.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $389.05 | Professional | None | $123.03 | $181.97 | $389.05 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $218.78 Typical High $467.74 | Professional | 22 · Increased work | $147.91 | $218.78 | $467.74 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $275.42 Typical High $575.44 | Professional | 50 · Both sides | $186.21 | $275.42 | $575.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $269.15 | Professional | 54 · Surgery only | $87.10 | $128.82 | $269.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $138.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $93.33 | $138.04 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $288.40 | Facility | None | $251.19 | $251.19 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $389.05 | Professional | None | $93.33 | $194.98 | $389.05 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $204.17 Typical High $1,202.26 | Facility | None | $67.61 | $204.17 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $331.13 | Professional | None | $158.49 | $281.84 | $331.13 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $295.12 | Professional | None | $74.13 | $154.88 | $295.12 |
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 $33.88 Median $33.88 Typical High $75.86 | Facility | 52 · Reduced service | $33.88 | $33.88 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $30.90 | Facility | 53 · Discontinued | $13.49 | $13.49 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $22.91 | Facility | 55 · Aftercare only | $10.23 | $10.23 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $15.49 | Facility | 56 · Pre-op care only | $6.76 | $6.76 | $15.49 |
Where North Dakota sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 26th of 51
$162
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.