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 $89.13 Median $125.89 Typical High $125.89 | Facility | None | $89.13 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $93.33 | Facility | 54 · Surgery only | $67.61 | $67.61 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $154.88 | Professional | None | $81.28 | $117.49 | $154.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $331.13 | Professional | None | $162.18 | $229.09 | $331.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $194.98 Median $275.42 Typical High $398.11 | Professional | 22 · Increased work | $194.98 | $275.42 | $398.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $234.42 | Professional | 54 · Surgery only | $112.20 | $162.18 | $234.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $407.38 | Professional | None | $131.83 | $218.78 | $407.38 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $269.15 | Facility | None | $89.13 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $269.15 | Professional | None | $128.82 | $218.78 | $269.15 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $234.42 | Professional | None | $95.50 | $165.96 | $234.42 |
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 $44.67 Median $44.67 Typical High $63.10 | Facility | 52 · Reduced service | $44.67 | $44.67 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $25.12 | Facility | 53 · Discontinued | $17.78 | $17.78 | $25.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $18.62 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $12.59 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $12.59 |
Where North Dakota sits
The same service costs 3.3 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· 9th of 51
$195
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.