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 $104.71 Median $134.90 Typical High $134.90 | Facility | None | $104.71 | $134.90 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $102.33 | Facility | 54 · Surgery only | $79.43 | $79.43 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $95.50 | Facility | 78 · Unplanned return to OR | $74.13 | $74.13 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $165.96 | Professional | None | $104.71 | $134.90 | $165.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $354.81 | Professional | None | $194.98 | $257.04 | $354.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $229.09 Median $309.03 Typical High $426.58 | Professional | 22 · Increased work | $229.09 | $309.03 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $177.83 | $251.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $144.54 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Facility | None | $257.04 | $257.04 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $398.11 | Professional | None | $162.18 | $269.15 | $398.11 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $269.15 | Facility | None | $104.71 | $134.90 | $269.15 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $295.12 | Professional | None | $138.04 | $251.19 | $295.12 |
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 $107.15 Median $199.53 Typical High $269.15 | Professional | None | $107.15 | $199.53 | $269.15 |
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 $52.48 Median $52.48 Typical High $67.61 | Facility | 52 · Reduced service | $52.48 | $52.48 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $26.92 | Facility | 53 · Discontinued | $20.89 | $20.89 | $26.92 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $20.42 | Facility | 55 · Aftercare only | $15.85 | $15.85 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $13.49 | Facility | 56 · Pre-op care only | $10.47 | $10.47 | $13.49 |
Where North Dakota sits
The same service costs 4.2 times more in Alaska 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· 8th of 51
$229
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.