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 $57.54 Median $112.20 Typical High $112.20 | Facility | None | $57.54 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $43.65 Median $48.98 Typical High $85.11 | Facility | 54 · Surgery only | $43.65 | $48.98 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $128.82 | Professional | None | $57.54 | $89.13 | $128.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $269.15 | Professional | None | $107.15 | $162.18 | $269.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $128.82 Median $194.98 Typical High $323.59 | Professional | 22 · Increased work | $128.82 | $194.98 | $323.59 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $112.20 Typical High $190.55 | Professional | 54 · Surgery only | $75.86 | $112.20 | $190.55 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Facility | None | $190.55 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $346.74 | Professional | None | $89.13 | $165.96 | $346.74 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $112.20 Typical High $263.03 | Facility | None | $57.54 | $112.20 | $263.03 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $245.47 | Professional | None | $114.82 | $208.93 | $245.47 |
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 $60.26 Median $114.82 Typical High $223.87 | Professional | None | $60.26 | $114.82 | $223.87 |
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 $28.84 Median $33.11 Typical High $56.23 | Facility | 52 · Reduced service | $28.84 | $33.11 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $13.18 Typical High $22.39 | Facility | 53 · Discontinued | $11.48 | $13.18 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $9.77 Typical High $16.98 | Facility | 55 · Aftercare only | $8.71 | $9.77 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.61 Typical High $11.22 | Facility | 56 · Pre-op care only | $5.75 | $6.61 | $11.22 |
Where North Dakota sits
The same service costs 3.9 times more in Wisconsin 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· 16th of 51
$132
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.