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 $117.49 Median $257.04 Typical High $257.04 | Facility | None | $117.49 | $257.04 | $257.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $100.00 Typical High $194.98 | Facility | 54 · Surgery only | $89.13 | $100.00 | $194.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $93.33 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $83.18 | $93.33 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $302.00 | Professional | None | $117.49 | $186.21 | $302.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $645.65 | Professional | None | $223.87 | $331.13 | $645.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $269.15 Median $398.11 Typical High $776.25 | Professional | 22 · Increased work | $269.15 | $398.11 | $776.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $457.09 | Professional | 54 · Surgery only | $154.88 | $234.42 | $457.09 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $251.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $165.96 | $251.19 | $489.78 |
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 $181.97 Median $398.11 Typical High $724.44 | Professional | None | $181.97 | $398.11 | $724.44 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $251.19 Typical High $436.52 | Facility | None | $117.49 | $251.19 | $436.52 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $549.54 | Professional | None | $257.04 | $436.52 | $549.54 |
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 $123.03 Median $257.04 Typical High $467.74 | Professional | None | $123.03 | $257.04 | $467.74 |
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 $58.88 Median $67.61 Typical High $128.82 | Facility | 52 · Reduced service | $58.88 | $67.61 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $26.92 Typical High $51.29 | Facility | 53 · Discontinued | $23.99 | $26.92 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $38.90 | Facility | 55 · Aftercare only | $17.78 | $20.42 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $25.70 | Facility | 56 · Pre-op care only | $11.75 | $13.49 | $25.70 |
Where North Dakota sits
The same service costs 3.9 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· 17th of 51
$269
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.