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 $107.15 Median $141.25 Typical High $141.25 | Facility | None | $107.15 | $141.25 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $107.15 | Facility | 54 · Surgery only | $81.28 | $81.28 | $107.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $100.00 | Facility | 78 · Unplanned return to OR | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $177.83 | Professional | None | $107.15 | $128.82 | $177.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $398.11 | Professional | None | $208.93 | $288.40 | $398.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $251.19 Median $346.74 Typical High $478.63 | Professional | 22 · Increased work | $251.19 | $346.74 | $478.63 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $199.53 Typical High $275.42 | Professional | 54 · Surgery only | $147.91 | $199.53 | $275.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $213.80 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $158.49 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $331.13 | Facility | None | $288.40 | $288.40 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $457.09 | Professional | None | $169.82 | $288.40 | $457.09 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $186.21 Typical High $2,454.71 | Facility | None | $107.15 | $186.21 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $309.03 | Professional | None | $131.83 | $213.80 | $309.03 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $263.03 | Professional | None | $112.20 | $194.98 | $263.03 |
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 $53.70 Median $53.70 Typical High $70.79 | Facility | 52 · Reduced service | $53.70 | $53.70 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $28.18 | Facility | 53 · Discontinued | $21.38 | $21.88 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $21.38 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $14.13 | Facility | 56 · Pre-op care only | $10.72 | $10.96 | $14.13 |
Where North Dakota sits
The same service costs 3.7 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
$245
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.