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 $162.18 Median $2,691.53 Typical High $2,951.21 | Facility | None | $162.18 | $2,691.53 | $2,951.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $134.90 Typical High $2,187.76 | Facility | 54 · Surgery only | $123.03 | $134.90 | $2,187.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $295.12 | Facility | 56 · Pre-op care only | $16.22 | $18.20 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $3,090.30 | Professional | None | $162.18 | $229.09 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $5,888.44 | Professional | None | $288.40 | $446.68 | $5,888.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $537.03 Typical High $6,918.31 | Professional | 22 · Increased work | $346.74 | $537.03 | $6,918.31 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $309.03 Typical High $4,073.80 | Professional | 54 · Surgery only | $204.17 | $309.03 | $4,073.80 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $44.67 Typical High $588.84 | Professional | 56 · Pre-op care only | $28.84 | $44.67 | $588.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $331.13 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $218.78 | $331.13 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,897.79 | Facility | None | $4,265.80 | $4,265.80 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $3,630.78 Typical High $7,762.47 | Professional | None | $245.47 | $3,630.78 | $7,762.47 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $2,951.21 Typical High $5,011.87 | Facility | None | $162.18 | $2,951.21 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $3,235.94 Median $5,888.44 Typical High $6,918.31 | Professional | None | $3,235.94 | $5,888.44 | $6,918.31 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $177.83 Median $1,995.26 Typical High $6,456.54 | Professional | None | $177.83 | $1,995.26 | $6,456.54 |
3 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 $81.28 Median $91.20 Typical High $1,445.44 | Facility | 52 · Reduced service | $81.28 | $91.20 | $1,445.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $588.84 | Facility | 53 · Discontinued | $32.36 | $36.31 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $26.92 Typical High $436.52 | Facility | 55 · Aftercare only | $24.55 | $26.92 | $436.52 |
Where North Dakota sits
The same service costs 33.1 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· 11th of 51
$2,951
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.