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 $141.25 Median $169.82 Typical High $177.83 | Facility | None | $141.25 | $169.82 | $177.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | 54 · Surgery only | $107.15 | $107.15 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $177.83 | Professional | None | $141.25 | $162.18 | $177.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $446.68 | Professional | None | $257.04 | $331.13 | $446.68 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $302.00 Median $398.11 Typical High $537.03 | Professional | 22 · Increased work | $302.00 | $398.11 | $537.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $229.09 Typical High $316.23 | Professional | 54 · Surgery only | $177.83 | $229.09 | $316.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $354.81 | Facility | None | $309.03 | $309.03 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $549.54 | Professional | None | $204.17 | $331.13 | $549.54 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $660.69 | Facility | None | $141.25 | $251.19 | $660.69 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $380.19 | Professional | None | $181.97 | $323.59 | $380.19 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $354.81 | Professional | None | $147.91 | $263.03 | $354.81 |
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 $70.79 Median $70.79 Typical High $87.10 | Facility | 52 · Reduced service | $70.79 | $70.79 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $35.48 | Facility | 53 · Discontinued | $28.18 | $28.18 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $26.30 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $17.78 | Facility | 56 · Pre-op care only | $14.13 | $14.13 | $17.78 |
Where North Dakota sits
The same service costs 3.4 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· 8th of 51
$309
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.