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 $208.93 Median $288.40 Typical High $302.00 | Facility | None | $208.93 | $288.40 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $229.09 | Facility | 54 · Surgery only | $158.49 | $158.49 | $229.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $302.00 | Professional | None | $194.98 | $208.93 | $302.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $741.31 | Professional | None | $380.19 | $512.86 | $741.31 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $616.60 Typical High $891.25 | Professional | 22 · Increased work | $457.09 | $616.60 | $891.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $363.08 Typical High $524.81 | Professional | 54 · Surgery only | $263.03 | $363.08 | $524.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $389.05 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $281.84 | $389.05 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $602.56 | Facility | None | $512.86 | $512.86 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $812.83 | Professional | None | $302.00 | $501.19 | $812.83 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $630.96 | Facility | None | $181.97 | $269.15 | $630.96 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $660.69 | Professional | None | $309.03 | $575.44 | $660.69 |
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 $213.80 Median $416.87 Typical High $645.65 | Professional | None | $213.80 | $416.87 | $645.65 |
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 $104.71 Median $104.71 Typical High $151.36 | Facility | 52 · Reduced service | $104.71 | $104.71 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $61.66 | Facility | 53 · Discontinued | $41.69 | $41.69 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $45.71 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.20 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $30.20 |
Where North Dakota sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 10th 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.