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 $263.03 Median $436.52 Typical High $436.52 | Facility | None | $263.03 | $436.52 | $436.52 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $331.13 | Facility | 54 · Surgery only | $199.53 | $213.80 | $331.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $199.53 Typical High $309.03 | Facility | 78 · Unplanned return to OR | $186.21 | $199.53 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $707.95 | Professional | None | $263.03 | $436.52 | $707.95 |
BCBS North Dakota Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,000.00 | Professional | None | $489.78 | $676.08 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | 22 · Increased work | $588.84 | $812.83 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,000.00 Typical High $1,513.56 | Professional | 50 · Both sides | $741.31 | $1,000.00 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $467.74 Typical High $707.95 | Professional | 54 · Surgery only | $338.84 | $467.74 | $707.95 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $501.19 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $363.08 | $501.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Facility | None | $691.83 | $691.83 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $977.24 | Professional | None | $363.08 | $676.08 | $977.24 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $616.60 Typical High $3,162.28 | Facility | None | $263.03 | $616.60 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $1,288.25 | Professional | None | $457.09 | $1,148.15 | $1,288.25 |
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 $281.84 Median $707.95 Typical High $1,288.25 | Professional | None | $281.84 | $707.95 | $1,288.25 |
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 $131.83 Median $141.25 Typical High $218.78 | Facility | 52 · Reduced service | $131.83 | $141.25 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $87.10 | Facility | 53 · Discontinued | $53.70 | $56.23 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $66.07 | Facility | 55 · Aftercare only | $39.81 | $42.66 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $43.65 | Facility | 56 · Pre-op care only | $26.30 | $28.18 | $43.65 |
Where North Dakota sits
The same service costs 4.1 times more in Wisconsin than in Texas. 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· 21st of 51
$661
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.