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 $41.69 Median $70.79 Typical High $70.79 | Facility | None | $41.69 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $53.70 | Facility | 54 · Surgery only | $30.90 | $30.90 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $89.13 | Professional | None | $41.69 | $70.79 | $89.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $190.55 | Professional | None | $74.13 | $112.20 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $89.13 Median $134.90 Typical High $229.09 | Professional | 22 · Increased work | $89.13 | $134.90 | $229.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $134.90 | Professional | 54 · Surgery only | $52.48 | $83.18 | $134.90 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $83.18 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $56.23 | $83.18 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $151.36 | Facility | None | $131.83 | $131.83 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $208.93 | Professional | None | $60.26 | $112.20 | $208.93 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $107.15 Typical High $263.03 | Facility | None | $41.69 | $107.15 | $263.03 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $154.88 | Professional | None | $72.44 | $131.83 | $154.88 |
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 $43.65 Median $79.43 Typical High $141.25 | Professional | None | $43.65 | $79.43 | $141.25 |
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 $20.89 Median $20.89 Typical High $35.48 | Facility | 52 · Reduced service | $20.89 | $20.89 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $14.13 | Facility | 53 · Discontinued | $8.32 | $8.32 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $10.72 | Facility | 55 · Aftercare only | $6.31 | $6.31 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $7.08 | Facility | 56 · Pre-op care only | $4.17 | $4.17 | $7.08 |
Where North Dakota sits
The same service costs 3.2 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
$91.20
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.