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 $40.74 Median $70.79 Typical High $70.79 | Facility | None | $40.74 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $52.48 | Facility | 54 · Surgery only | $30.20 | $30.20 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $70.79 Typical High $81.28 | Professional | None | $40.74 | $70.79 | $81.28 |
BCBS North Dakota Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $190.55 | Professional | None | $72.44 | $107.15 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $87.10 Median $128.82 Typical High $223.87 | Professional | 22 · Increased work | $87.10 | $128.82 | $223.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $83.18 Typical High $131.83 | Professional | 54 · Surgery only | $50.12 | $83.18 | $131.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $81.28 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $53.70 | $81.28 | $141.25 |
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 $69.18 Median $120.23 Typical High $234.42 | Professional | None | $69.18 | $120.23 | $234.42 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $107.15 Typical High $263.03 | Facility | None | $40.74 | $107.15 | $263.03 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $151.36 | Professional | None | $72.44 | $128.82 | $151.36 |
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 $42.66 Median $77.62 Typical High $138.04 | Professional | None | $42.66 | $77.62 | $138.04 |
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 $20.42 Median $20.42 Typical High $35.48 | Facility | 52 · Reduced service | $20.42 | $20.42 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $14.13 | Facility | 53 · Discontinued | $8.13 | $8.13 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $10.47 | Facility | 55 · Aftercare only | $6.03 | $6.03 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $7.08 | Facility | 56 · Pre-op care only | $4.07 | $4.07 | $7.08 |
Where North Dakota sits
The same service costs 3.4 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· 20th 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.