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 $109.65 Median $141.25 Typical High $141.25 | Facility | None | $109.65 | $141.25 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $107.15 | Facility | 54 · Surgery only | $83.18 | $83.18 | $107.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | 78 · Unplanned return to OR | $77.62 | $77.62 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $169.82 | Professional | None | $109.65 | $134.90 | $169.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $346.74 | Professional | None | $199.53 | $257.04 | $346.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $239.88 Median $309.03 Typical High $416.87 | Professional | 22 · Increased work | $239.88 | $309.03 | $416.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $177.83 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $190.55 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $147.91 | $190.55 | $263.03 |
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 $169.82 Median $275.42 Typical High $407.38 | Professional | None | $169.82 | $275.42 | $407.38 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $269.15 | Facility | None | $109.65 | $141.25 | $269.15 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $309.03 | Professional | None | $144.54 | $263.03 | $309.03 |
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 $112.20 Median $208.93 Typical High $281.84 | Professional | None | $112.20 | $208.93 | $281.84 |
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 $54.95 Median $54.95 Typical High $70.79 | Facility | 52 · Reduced service | $54.95 | $54.95 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $28.18 | Facility | 53 · Discontinued | $21.88 | $21.88 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $21.38 | Facility | 55 · Aftercare only | $16.60 | $16.60 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $14.13 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $14.13 |
Where North Dakota sits
The same service costs 4.1 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
$234
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.