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 $269.15 Median $1,071.52 Typical High $1,071.52 | Facility | None | $269.15 | $1,071.52 | $1,071.52 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $812.83 | Facility | 54 · Surgery only | $204.17 | $218.78 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $1,318.26 | Professional | None | $269.15 | $371.54 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $2,398.83 | Professional | None | $489.78 | $741.31 | $2,398.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $588.84 Median $891.25 Typical High $2,884.03 | Professional | 22 · Increased work | $588.84 | $891.25 | $2,884.03 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,096.48 Typical High $3,548.13 | Professional | 50 · Both sides | $741.31 | $1,096.48 | $3,548.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $512.86 Typical High $1,659.59 | Professional | 54 · Surgery only | $346.74 | $512.86 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $549.54 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $371.54 | $549.54 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Facility | None | $1,659.59 | $1,659.59 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,412.54 Typical High $2,951.21 | Professional | None | $380.19 | $1,412.54 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $1,995.26 Typical High $4,168.69 | Facility | None | $269.15 | $1,995.26 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,290.87 Typical High $2,398.83 | Professional | None | $1,096.48 | $2,290.87 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $288.40 Median $1,000.00 Typical High $2,398.83 | Professional | None | $288.40 | $1,000.00 | $2,398.83 |
2 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 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $162.18 | Facility | 55 · Aftercare only | $40.74 | $43.65 | $162.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $107.15 | Facility | 56 · Pre-op care only | $26.92 | $28.84 | $107.15 |
Where North Dakota sits
The same service costs 4.8 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· 41st of 51
$1,096
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.