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 $144.54 Median $269.15 Typical High $288.40 | Facility | None | $144.54 | $269.15 | $288.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $218.78 | Facility | 54 · Surgery only | $107.15 | $107.15 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $288.40 | Professional | None | $138.04 | $144.54 | $288.40 |
BCBS North Dakota Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $707.95 | Professional | None | $251.19 | $371.54 | $707.95 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $302.00 Median $446.68 Typical High $851.14 | Professional | 22 · Increased work | $302.00 | $446.68 | $851.14 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $562.34 Typical High $1,047.13 | Professional | 50 · Both sides | $380.19 | $562.34 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $489.78 | Professional | 54 · Surgery only | $177.83 | $263.03 | $489.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $724.44 | Professional | None | $204.17 | $371.54 | $724.44 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $380.19 Typical High $3,162.28 | Facility | None | $144.54 | $380.19 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $616.60 | Professional | None | $295.12 | $524.81 | $616.60 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $588.84 | Professional | None | $151.36 | $295.12 | $588.84 |
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 $72.44 Median $72.44 Typical High $144.54 | Facility | 52 · Reduced service | $72.44 | $72.44 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $57.54 | Facility | 53 · Discontinued | $28.84 | $28.84 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $43.65 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $28.84 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $28.84 |
Where North Dakota sits
The same service costs 5.8 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· 15th of 51
$339
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.