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 $158.49 Median $302.00 Typical High $302.00 | Facility | None | $158.49 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $223.87 | Facility | 54 · Surgery only | $117.49 | $128.82 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $338.84 | Professional | None | $158.49 | $177.83 | $338.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $758.58 | Professional | None | $275.42 | $416.87 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $331.13 Median $501.19 Typical High $912.01 | Professional | 22 · Increased work | $331.13 | $501.19 | $912.01 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $630.96 Typical High $1,122.02 | Professional | 50 · Both sides | $416.87 | $630.96 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $295.12 Typical High $524.81 | Professional | 54 · Surgery only | $190.55 | $295.12 | $524.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $316.23 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $204.17 | $316.23 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $977.24 | Professional | None | $234.42 | $457.09 | $977.24 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $436.52 Typical High $1,202.26 | Facility | None | $158.49 | $436.52 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $645.65 | Professional | None | $309.03 | $549.54 | $645.65 |
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 $162.18 Median $309.03 Typical High $602.56 | Professional | None | $162.18 | $309.03 | $602.56 |
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 $79.43 Median $85.11 Typical High $151.36 | Facility | 52 · Reduced service | $79.43 | $85.11 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $60.26 | Facility | 53 · Discontinued | $31.62 | $33.88 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $44.67 | Facility | 55 · Aftercare only | $23.44 | $25.70 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $30.20 | Facility | 56 · Pre-op care only | $15.85 | $16.98 | $30.20 |
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· 20th of 51
$372
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.