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 $1,445.44 Typical High $1,548.82 | Facility | None | $117.49 | $1,445.44 | $1,548.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $1,148.15 | Facility | 54 · Surgery only | $87.10 | $93.33 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $1,819.70 | Professional | None | $109.65 | $229.09 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $3,162.28 | Professional | None | $208.93 | $316.23 | $3,162.28 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $251.19 Median $380.19 Typical High $3,715.35 | Professional | 22 · Increased work | $251.19 | $380.19 | $3,715.35 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $467.74 Typical High $4,677.35 | Professional | 50 · Both sides | $316.23 | $467.74 | $4,677.35 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $218.78 Typical High $2,187.76 | Professional | 54 · Surgery only | $147.91 | $218.78 | $2,187.76 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $234.42 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $158.49 | $234.42 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,511.89 | Facility | None | $2,187.76 | $2,187.76 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $1,862.09 Typical High $3,890.45 | Professional | None | $162.18 | $1,862.09 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $1,023.29 Typical High $2,137.96 | Facility | None | $117.49 | $1,023.29 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $3,019.95 Typical High $3,311.31 | Professional | None | $1,548.82 | $3,019.95 | $3,311.31 |
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 $125.89 Median $1,412.54 Typical High $3,235.94 | Professional | None | $125.89 | $1,412.54 | $3,235.94 |
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 $63.10 Typical High $776.25 | Facility | 52 · Reduced service | $58.88 | $63.10 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $309.03 | Facility | 53 · Discontinued | $23.44 | $25.12 | $309.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $229.09 | Facility | 55 · Aftercare only | $17.38 | $18.62 | $229.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $154.88 | Facility | 56 · Pre-op care only | $11.75 | $12.59 | $154.88 |
Where North Dakota sits
The same service costs 10.5 times more in Alaska than in Nebraska. 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· 13th of 51
$1,479
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.