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 $91.20 Median $426.58 Typical High $446.68 | Facility | None | $91.20 | $426.58 | $446.68 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $331.13 | Facility | 54 · Surgery only | $69.18 | $69.18 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $446.68 | Professional | None | $91.20 | $109.65 | $446.68 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $891.25 | Professional | None | $147.91 | $218.78 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $177.83 Median $263.03 Typical High $1,071.52 | Professional | 22 · Increased work | $177.83 | $263.03 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $151.36 Typical High $616.60 | Professional | 54 · Surgery only | $102.33 | $151.36 | $616.60 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $741.31 | Facility | None | $645.65 | $645.65 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $549.54 Typical High $1,023.29 | Professional | None | $114.82 | $549.54 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $446.68 Typical High $776.25 | Facility | None | $91.20 | $446.68 | $776.25 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $954.99 | Professional | None | $446.68 | $794.33 | $954.99 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $95.50 Median $389.05 Typical High $851.14 | Professional | None | $95.50 | $389.05 | $851.14 |
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 $45.71 Median $45.71 Typical High $218.78 | Facility | 52 · Reduced service | $45.71 | $45.71 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $89.13 | Facility | 53 · Discontinued | $18.20 | $18.20 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $66.07 | Facility | 55 · Aftercare only | $13.80 | $13.80 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $44.67 | Facility | 56 · Pre-op care only | $9.12 | $9.12 | $44.67 |
Where North Dakota sits
The same service costs 7.8 times more in Oklahoma 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· 24th of 51
$447
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.