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 $43.65 Median $85.11 Typical High $1,288.25 | Facility | None | $43.65 | $85.11 | $1,288.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $63.10 | Facility | 54 · Surgery only | $33.11 | $33.11 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $89.13 Typical High $218.78 | Professional | None | $43.65 | $89.13 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $63.10 Typical High $72.44 | Professional | 54 · Surgery only | $33.11 | $63.10 | $72.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $223.87 | Professional | None | $75.86 | $123.03 | $223.87 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $91.20 Median $147.91 Typical High $269.15 | Professional | 22 · Increased work | $91.20 | $147.91 | $269.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $87.10 Typical High $154.88 | Professional | 54 · Surgery only | $53.70 | $87.10 | $154.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $93.33 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $57.54 | $93.33 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $239.88 | Professional | None | $70.79 | $123.03 | $239.88 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $85.11 Typical High $501.19 | Facility | None | $43.65 | $85.11 | $501.19 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $1,778.28 | Professional | None | $85.11 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $177.83 | Professional | None | $45.71 | $102.33 | $177.83 |
8 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 $21.88 Median $21.88 Typical High $41.69 | Facility | 52 · Reduced service | $21.88 | $21.88 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $16.98 | Facility | 53 · Discontinued | $8.71 | $8.71 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $12.59 | Facility | 55 · Aftercare only | $6.61 | $6.61 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $8.51 | Facility | 56 · Pre-op care only | $4.37 | $4.37 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $21.88 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $8.71 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $6.61 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.37 | $8.51 | $9.77 |
Where North Dakota sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 16th of 51
$110
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.