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 $87.10 Median $281.84 Typical High $288.40 | Facility | None | $87.10 | $281.84 | $288.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $69.18 Typical High $218.78 | Facility | 54 · Surgery only | $66.07 | $69.18 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $288.40 | Professional | None | $87.10 | $109.65 | $288.40 |
BCBS North Dakota Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $588.84 | Professional | None | $154.88 | $234.42 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $186.21 Median $281.84 Typical High $707.95 | Professional | 22 · Increased work | $186.21 | $281.84 | $707.95 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $346.74 Typical High $870.96 | Professional | 50 · Both sides | $234.42 | $346.74 | $870.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $407.38 | Professional | 54 · Surgery only | $109.65 | $162.18 | $407.38 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $173.78 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $117.49 | $173.78 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Facility | None | $426.58 | $426.58 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $758.58 | Professional | None | $120.23 | $251.19 | $758.58 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $251.19 Typical High $489.78 | Facility | None | $87.10 | $251.19 | $489.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $630.96 | Professional | None | $295.12 | $512.86 | $630.96 |
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 $93.33 Median $257.04 Typical High $549.54 | Professional | None | $93.33 | $257.04 | $549.54 |
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 $43.65 Median $46.77 Typical High $144.54 | Facility | 52 · Reduced service | $43.65 | $46.77 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $57.54 | Facility | 53 · Discontinued | $17.38 | $18.62 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $43.65 | Facility | 55 · Aftercare only | $13.18 | $14.13 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $28.84 | Facility | 56 · Pre-op care only | $8.71 | $9.33 | $28.84 |
Where North Dakota sits
The same service costs 3.6 times more in Wisconsin 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· 30th of 51
$269
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.