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 $676.08 Median $794.33 Typical High $912.01 | Facility | None | $676.08 | $794.33 | $912.01 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $91.20 | Facility | 56 · Pre-op care only | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $912.01 | Professional | None | $676.08 | $707.95 | $912.01 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,479.11 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,288.25 Median $1,778.28 Typical High $2,454.71 | Professional | 22 · Increased work | $1,288.25 | $1,778.28 | $2,454.71 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $204.17 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,659.59 | Facility | None | $1,445.44 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,238.72 | Professional | None | $912.01 | $1,513.56 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,630.27 | Facility | None | $676.08 | $1,174.90 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,995.26 | Professional | None | $954.99 | $1,548.82 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,698.24 | Professional | None | $707.95 | $1,258.93 | $1,698.24 |
5 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 $338.84 Median $338.84 Typical High $457.09 | Facility | 52 · Reduced service | $338.84 | $338.84 | $457.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $181.97 | Facility | 53 · Discontinued | $134.90 | $134.90 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $691.83 | Facility | 54 · Surgery only | $512.86 | $512.86 | $691.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $138.04 | Facility | 55 · Aftercare only | $102.33 | $102.33 | $138.04 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $645.65 | Facility | 78 · Unplanned return to OR | $478.63 | $478.63 | $645.65 |
Where North Dakota sits
The same service costs 5.2 times more in Alaska 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
$1,349
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.