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 $64.57 Median $95.50 Typical High $95.50 | Facility | None | $64.57 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $72.44 | Facility | 54 · Surgery only | $48.98 | $48.98 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $114.82 | Professional | None | $60.26 | $89.13 | $114.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $257.04 | Professional | None | $117.49 | $165.96 | $257.04 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $141.25 Median $204.17 Typical High $309.03 | Professional | 22 · Increased work | $141.25 | $204.17 | $309.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $177.83 | Professional | 54 · Surgery only | $81.28 | $117.49 | $177.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $125.89 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $87.10 | $125.89 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $204.17 | Facility | None | $177.83 | $177.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $275.42 | Professional | None | $93.33 | $165.96 | $275.42 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $114.82 Typical High $660.69 | Facility | None | $64.57 | $114.82 | $660.69 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $208.93 | Professional | None | $100.00 | $165.96 | $208.93 |
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 $69.18 Median $120.23 Typical High $177.83 | Professional | None | $69.18 | $120.23 | $177.83 |
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 $32.36 Median $32.36 Typical High $47.86 | Facility | 52 · Reduced service | $32.36 | $32.36 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $19.05 | Facility | 53 · Discontinued | $13.18 | $13.18 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $14.45 | Facility | 55 · Aftercare only | $9.77 | $9.77 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $9.55 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $9.55 |
Where North Dakota sits
The same service costs 3.6 times more in Wisconsin 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· 10th of 51
$141
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.