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 $229.09 Median $288.40 Typical High $363.08 | Facility | None | $229.09 | $288.40 | $363.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $269.15 | Facility | 54 · Surgery only | $173.78 | $173.78 | $269.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $251.19 | Facility | 78 · Unplanned return to OR | $162.18 | $162.18 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $363.08 | Professional | None | $204.17 | $288.40 | $363.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $758.58 | Professional | None | $389.05 | $524.81 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $630.96 Typical High $912.01 | Professional | 22 · Increased work | $467.74 | $630.96 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $363.08 Typical High $537.03 | Professional | 54 · Surgery only | $269.15 | $363.08 | $537.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Facility | None | $524.81 | $524.81 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $933.25 | Professional | None | $302.00 | $512.86 | $933.25 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $630.96 | Facility | None | $134.90 | $263.03 | $630.96 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $776.25 | Professional | None | $371.54 | $645.65 | $776.25 |
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 $239.88 Median $426.58 Typical High $691.83 | Professional | None | $239.88 | $426.58 | $691.83 |
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 $114.82 Median $114.82 Typical High $177.83 | Facility | 52 · Reduced service | $114.82 | $114.82 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $72.44 | Facility | 53 · Discontinued | $46.77 | $46.77 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $53.70 | Facility | 55 · Aftercare only | $34.67 | $34.67 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $36.31 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $36.31 |
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· 9th of 51
$457
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.