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 $204.17 Median $251.19 Typical High $251.19 | Facility | None | $204.17 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $190.55 | Facility | 54 · Surgery only | $154.88 | $154.88 | $190.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $309.03 | Professional | None | $199.53 | $245.47 | $309.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $660.69 | Professional | None | $380.19 | $489.78 | $660.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $588.84 Typical High $794.33 | Professional | 22 · Increased work | $457.09 | $588.84 | $794.33 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $263.03 | $338.84 | $467.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $851.14 | Professional | None | $309.03 | $512.86 | $851.14 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $389.05 Typical High $1,202.26 | Facility | None | $204.17 | $389.05 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $549.54 | Professional | None | $245.47 | $416.87 | $549.54 |
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 $213.80 Median $380.19 Typical High $489.78 | Professional | None | $213.80 | $380.19 | $489.78 |
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 $102.33 Median $102.33 Typical High $125.89 | Facility | 52 · Reduced service | $102.33 | $102.33 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $50.12 | Facility | 53 · Discontinued | $41.69 | $41.69 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $38.02 | Facility | 55 · Aftercare only | $30.90 | $30.90 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $25.12 | Facility | 56 · Pre-op care only | $20.42 | $20.42 | $25.12 |
Where North Dakota sits
The same service costs 4.7 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
$447
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.