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 $169.82 Median $218.78 Typical High $281.84 | Facility | None | $169.82 | $218.78 | $281.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $213.80 | Facility | 54 · Surgery only | $125.89 | $125.89 | $213.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $117.49 | $117.49 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $281.84 | Professional | None | $147.91 | $169.82 | $281.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $562.34 | Professional | None | $275.42 | $380.19 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $331.13 Median $446.68 Typical High $676.08 | Professional | 22 · Increased work | $331.13 | $446.68 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $398.11 | Professional | 54 · Surgery only | $194.98 | $263.03 | $398.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $281.84 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $208.93 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $457.09 | Facility | None | $398.11 | $398.11 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $616.60 | Professional | None | $245.47 | $398.11 | $616.60 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $478.63 | Facility | None | $125.89 | $251.19 | $478.63 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $602.56 | Professional | None | $288.40 | $512.86 | $602.56 |
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 $173.78 Median $316.23 Typical High $549.54 | Professional | None | $173.78 | $316.23 | $549.54 |
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 $85.11 Median $85.11 Typical High $141.25 | Facility | 52 · Reduced service | $85.11 | $85.11 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $56.23 | Facility | 53 · Discontinued | $33.88 | $33.88 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $42.66 | Facility | 55 · Aftercare only | $25.12 | $25.12 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $28.18 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $28.18 |
Where North Dakota sits
The same service costs 3.7 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· 13th of 51
$324
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.