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 $363.08 Median $512.86 Typical High $524.81 | Facility | None | $363.08 | $512.86 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $389.05 | Facility | 54 · Surgery only | $275.42 | $275.42 | $389.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $52.48 | Facility | 56 · Pre-op care only | $36.31 | $36.31 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $257.04 | $257.04 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $524.81 | Professional | None | $363.08 | $371.54 | $524.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,288.25 | Professional | None | $660.69 | $933.25 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $1,122.02 Typical High $1,548.82 | Professional | 22 · Increased work | $794.33 | $1,122.02 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $467.74 | $645.65 | $891.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $128.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $501.19 | $691.83 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Facility | None | $933.25 | $933.25 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,445.44 | Professional | None | $616.60 | $933.25 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $676.08 Typical High $1,548.82 | Facility | None | $363.08 | $676.08 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $3,019.95 | Professional | None | $524.81 | $954.99 | $3,019.95 |
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 $371.54 Median $691.83 Typical High $1,023.29 | Professional | None | $371.54 | $691.83 | $1,023.29 |
3 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 $181.97 Median $181.97 Typical High $263.03 | Facility | 52 · Reduced service | $181.97 | $181.97 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $104.71 | Facility | 53 · Discontinued | $72.44 | $72.44 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $77.62 | Facility | 55 · Aftercare only | $54.95 | $54.95 | $77.62 |
Where North Dakota sits
The same service costs 4.4 times more in Alaska 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· 8th of 51
$832
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.