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 $1,174.90 Median $1,445.44 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,445.44 | $1,479.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $147.91 | Facility | 56 · Pre-op care only | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,230.27 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,884.03 | $3,981.07 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,511.89 Median $3,388.44 Typical High $4,786.30 | Professional | 22 · Increased work | $2,511.89 | $3,388.44 | $4,786.30 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $288.40 Typical High $398.11 | Professional | 56 · Pre-op care only | $208.93 | $288.40 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,951.21 | Facility | None | $2,570.40 | $2,570.40 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,754.23 Typical High $4,677.35 | Professional | None | $1,698.24 | $2,754.23 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $4,466.84 | Facility | None | $1,174.90 | $2,137.96 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,454.71 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,230.27 | $2,089.30 | $2,818.38 |
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 $588.84 Median $588.84 Typical High $741.31 | Facility | 52 · Reduced service | $588.84 | $588.84 | $741.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $302.00 | Facility | 53 · Discontinued | $234.42 | $234.42 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Facility | 54 · Surgery only | $891.25 | $891.25 | $1,122.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $223.87 | Facility | 55 · Aftercare only | $177.83 | $177.83 | $223.87 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Facility | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,047.13 |
Where North Dakota sits
The same service costs 5.2 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
$2,570
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.