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 $114.82 Median $190.55 Typical High $229.09 | Facility | None | $114.82 | $190.55 | $229.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $100.00 Typical High $144.54 | Facility | 54 · Surgery only | $85.11 | $100.00 | $144.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $93.33 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $79.43 | $93.33 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $245.47 | Professional | None | $114.82 | $190.55 | $245.47 |
BCBS North Dakota Setting Facility Modifier None Typical Low $138.04 Median $162.18 Typical High $407.38 | Facility | None | $138.04 | $162.18 | $407.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $512.86 | Professional | None | $229.09 | $323.59 | $512.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $275.42 Median $389.05 Typical High $616.60 | Professional | 22 · Increased work | $275.42 | $389.05 | $616.60 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $229.09 Typical High $363.08 | Professional | 54 · Surgery only | $162.18 | $229.09 | $363.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $245.47 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $173.78 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $660.69 | Professional | None | $181.97 | $331.13 | $660.69 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $323.59 | Facility | None | $114.82 | $190.55 | $323.59 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $416.87 | Professional | None | $194.98 | $338.84 | $416.87 |
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 $117.49 Median $213.80 Typical High $354.81 | Professional | None | $117.49 | $213.80 | $354.81 |
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 $57.54 Median $67.61 Typical High $95.50 | Facility | 52 · Reduced service | $57.54 | $67.61 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $38.90 | Facility | 53 · Discontinued | $22.91 | $26.92 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $28.84 | Facility | 55 · Aftercare only | $16.98 | $19.95 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $19.05 | Facility | 56 · Pre-op care only | $11.48 | $13.49 | $19.05 |
Where North Dakota sits
The same service costs 4.5 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· 12th of 51
$263
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.