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 $52.48 Median $95.50 Typical High $95.50 | Facility | None | $52.48 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $72.44 | Facility | 54 · Surgery only | $38.90 | $38.90 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $131.83 | Professional | None | $52.48 | $81.28 | $131.83 |
BCBS North Dakota Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $245.47 | Professional | None | $93.33 | $141.25 | $245.47 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $112.20 Median $169.82 Typical High $295.12 | Professional | 22 · Increased work | $112.20 | $169.82 | $295.12 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $173.78 | Professional | 54 · Surgery only | $66.07 | $97.72 | $173.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $104.71 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $70.79 | $104.71 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Facility | None | $169.82 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $309.03 | Professional | None | $75.86 | $158.49 | $309.03 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $125.89 Typical High $269.15 | Facility | None | $52.48 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $208.93 | Professional | None | $97.72 | $169.82 | $208.93 |
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 $53.70 Median $100.00 Typical High $181.97 | Professional | None | $53.70 | $100.00 | $181.97 |
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 $26.30 Median $26.30 Typical High $47.86 | Facility | 52 · Reduced service | $26.30 | $26.30 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $19.05 | Facility | 53 · Discontinued | $10.47 | $10.47 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $14.45 | Facility | 55 · Aftercare only | $7.76 | $7.76 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $9.55 | Facility | 56 · Pre-op care only | $5.25 | $5.25 | $9.55 |
Where North Dakota sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 19th of 51
$117
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.