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 $93.33 Median $125.89 Typical High $125.89 | Facility | None | $93.33 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | 54 · Surgery only | $70.79 | $70.79 | $95.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $66.07 Typical High $89.13 | Facility | 78 · Unplanned return to OR | $66.07 | $66.07 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $151.36 | Professional | None | $93.33 | $114.82 | $151.36 |
BCBS North Dakota Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $338.84 | Professional | None | $173.78 | $245.47 | $338.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $208.93 Median $295.12 Typical High $407.38 | Professional | 22 · Increased work | $208.93 | $295.12 | $407.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $234.42 | Professional | 54 · Surgery only | $120.23 | $169.82 | $234.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $128.82 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $281.84 | Facility | None | $245.47 | $245.47 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $436.52 | Professional | None | $144.54 | $251.19 | $436.52 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $1,096.48 | Facility | None | $93.33 | $165.96 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $275.42 | Professional | None | $128.82 | $223.87 | $275.42 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $239.88 | Professional | None | $95.50 | $173.78 | $239.88 |
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 $46.77 Median $46.77 Typical High $63.10 | Facility | 52 · Reduced service | $46.77 | $46.77 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $25.70 | Facility | 53 · Discontinued | $18.62 | $18.62 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $19.05 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $12.59 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $12.59 |
Where North Dakota sits
The same service costs 3.5 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· 9th of 51
$214
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.