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 $125.89 Median $165.96 Typical High $181.97 | Facility | None | $125.89 | $165.96 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $123.03 | Facility | 54 · Surgery only | $93.33 | $93.33 | $123.03 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $114.82 | Facility | 78 · Unplanned return to OR | $87.10 | $87.10 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $208.93 | Professional | None | $117.49 | $144.54 | $208.93 |
BCBS North Dakota Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $446.68 | Professional | None | $239.88 | $323.59 | $446.68 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $288.40 Median $389.05 Typical High $537.03 | Professional | 22 · Increased work | $288.40 | $389.05 | $537.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $229.09 Typical High $316.23 | Professional | 54 · Surgery only | $165.96 | $229.09 | $316.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $245.47 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $177.83 | $245.47 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $380.19 | Facility | None | $331.13 | $331.13 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $602.56 | Professional | None | $199.53 | $338.84 | $602.56 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $275.42 Typical High $1,202.26 | Facility | None | $125.89 | $275.42 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $354.81 | Professional | None | $151.36 | $245.47 | $354.81 |
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 $128.82 Median $229.09 Typical High $309.03 | Professional | None | $128.82 | $229.09 | $309.03 |
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 $63.10 Median $63.10 Typical High $83.18 | Facility | 52 · Reduced service | $63.10 | $63.10 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $33.11 | Facility | 53 · Discontinued | $25.12 | $25.12 | $33.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $24.55 | Facility | 55 · Aftercare only | $18.62 | $19.05 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.60 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $16.60 |
Where North Dakota sits
The same service costs 3.9 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
$282
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.