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 $100.00 Median $151.36 Typical High $151.36 | Facility | None | $100.00 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $112.20 | Facility | 54 · Surgery only | $74.13 | $85.11 | $112.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $79.43 Typical High $104.71 | Facility | 78 · Unplanned return to OR | $69.18 | $79.43 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $165.96 | Professional | None | $100.00 | $117.49 | $165.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $380.19 | Professional | None | $190.55 | $263.03 | $380.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | 22 · Increased work | $229.09 | $316.23 | $457.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $186.21 | $263.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $199.53 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $144.54 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Facility | None | $263.03 | $263.03 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $478.63 | Professional | None | $154.88 | $257.04 | $478.63 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $173.78 Typical High $1,096.48 | Facility | None | $100.00 | $173.78 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $323.59 | Professional | None | $151.36 | $275.42 | $323.59 |
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 $102.33 Median $186.21 Typical High $295.12 | Professional | None | $102.33 | $186.21 | $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 $48.98 Median $57.54 Typical High $75.86 | Facility | 52 · Reduced service | $48.98 | $57.54 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $30.20 | Facility | 53 · Discontinued | $19.95 | $22.91 | $30.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $22.39 | Facility | 55 · Aftercare only | $14.79 | $16.98 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $15.14 | Facility | 56 · Pre-op care only | $10.00 | $11.48 | $15.14 |
Where North Dakota sits
The same service costs 4.4 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· 8th of 51
$234
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.