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 $85.11 Median $112.20 Typical High $112.20 | Facility | None | $85.11 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $83.18 | Facility | 54 · Surgery only | $63.10 | $63.10 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $58.88 Typical High $77.62 | Facility | 78 · Unplanned return to OR | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $138.04 | Professional | None | $83.18 | $109.65 | $138.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $295.12 | Professional | None | $165.96 | $213.80 | $295.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $199.53 Median $257.04 Typical High $354.81 | Professional | 22 · Increased work | $199.53 | $257.04 | $354.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $204.17 | Professional | 54 · Surgery only | $117.49 | $151.36 | $204.17 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $162.18 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $162.18 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Facility | None | $204.17 | $204.17 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $371.54 | Professional | None | $131.83 | $213.80 | $371.54 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $263.03 | Facility | None | $85.11 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $239.88 | Professional | None | $114.82 | $204.17 | $239.88 |
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 $87.10 Median $158.49 Typical High $213.80 | Professional | None | $87.10 | $158.49 | $213.80 |
1 more rate 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 $42.66 Median $42.66 Typical High $56.23 | Facility | 52 · Reduced service | $42.66 | $42.66 | $56.23 |
Where North Dakota sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 7th of 51
$195
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.