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 $165.96 Median $186.21 Typical High $186.21 | Facility | None | $165.96 | $186.21 | $186.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $138.04 | Facility | 54 · Surgery only | $123.03 | $123.03 | $138.04 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $131.83 | Facility | 78 · Unplanned return to OR | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $194.98 | Professional | None | $165.96 | $173.78 | $194.98 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $467.74 | Professional | None | $288.40 | $371.54 | $467.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $446.68 Typical High $562.34 | Professional | 22 · Increased work | $346.74 | $446.68 | $562.34 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $257.04 | $323.59 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $275.42 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $218.78 | $275.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $549.54 | Professional | None | $239.88 | $389.05 | $549.54 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $281.84 Typical High $2,454.71 | Facility | None | $165.96 | $281.84 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $398.11 | Professional | None | $194.98 | $338.84 | $398.11 |
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 $173.78 Median $309.03 Typical High $371.54 | Professional | None | $173.78 | $309.03 | $371.54 |
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 $83.18 Median $83.18 Typical High $93.33 | Facility | 52 · Reduced service | $83.18 | $83.18 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $37.15 | Facility | 53 · Discontinued | $33.11 | $33.11 | $37.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $28.18 | Facility | 55 · Aftercare only | $24.55 | $24.55 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $18.62 | Facility | 56 · Pre-op care only | $16.60 | $16.60 | $18.62 |
Where North Dakota sits
The same service costs 4.9 times more in Oklahoma 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· 8th of 51
$347
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.