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 $117.49 Median $269.15 Typical High $269.15 | Facility | None | $117.49 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $95.50 Typical High $204.17 | Facility | 54 · Surgery only | $87.10 | $95.50 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $295.12 | Professional | None | $117.49 | $134.90 | $295.12 |
BCBS North Dakota Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $645.65 | Professional | None | $208.93 | $316.23 | $645.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $251.19 Median $380.19 Typical High $776.25 | Professional | 22 · Increased work | $251.19 | $380.19 | $776.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $457.09 | Professional | 54 · Surgery only | $144.54 | $218.78 | $457.09 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $234.42 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $154.88 | $234.42 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $724.44 | Professional | None | $173.78 | $389.05 | $724.44 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $354.81 Typical High $1,202.26 | Facility | None | $117.49 | $354.81 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $588.84 | Professional | None | $275.42 | $501.19 | $588.84 |
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 $123.03 Median $251.19 Typical High $537.03 | Professional | None | $123.03 | $251.19 | $537.03 |
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 $58.88 Median $64.57 Typical High $134.90 | Facility | 52 · Reduced service | $58.88 | $64.57 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $53.70 | Facility | 53 · Discontinued | $23.44 | $25.70 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $19.05 Typical High $40.74 | Facility | 55 · Aftercare only | $17.38 | $19.05 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $26.92 | Facility | 56 · Pre-op care only | $11.75 | $12.88 | $26.92 |
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· 28th of 51
$282
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.