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 $186.21 Median $223.87 Typical High $223.87 | Facility | None | $186.21 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | 54 · Surgery only | $141.25 | $141.25 | $169.82 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | 78 · Unplanned return to OR | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $245.47 | Professional | None | $186.21 | $223.87 | $245.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $562.34 | Professional | None | $338.84 | $426.58 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $407.38 Median $512.86 Typical High $676.08 | Professional | 22 · Increased work | $407.38 | $512.86 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $398.11 | Professional | 54 · Surgery only | $239.88 | $295.12 | $398.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $257.04 | $316.23 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Facility | None | $389.05 | $389.05 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $707.95 | Professional | None | $275.42 | $436.52 | $707.95 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $2,511.89 | Facility | None | $186.21 | $331.13 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $489.78 | Professional | None | $234.42 | $407.38 | $489.78 |
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 $194.98 Median $346.74 Typical High $436.52 | Professional | None | $194.98 | $346.74 | $436.52 |
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 $93.33 Median $93.33 Typical High $112.20 | Facility | 52 · Reduced service | $93.33 | $93.33 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $44.67 | Facility | 53 · Discontinued | $38.02 | $38.02 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $33.88 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $22.39 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $22.39 |
Where North Dakota sits
The same service costs 5.6 times more in Oklahoma 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
$407
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.