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 $74.13 Median $144.54 Typical High $1,148.15 | Facility | None | $74.13 | $144.54 | $1,148.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $109.65 | Facility | 54 · Surgery only | $56.23 | $56.23 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $169.82 | Professional | None | $72.44 | $109.65 | $169.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Facility | None | $954.99 | $954.99 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $371.54 | Professional | None | $138.04 | $204.17 | $371.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $162.18 Median $245.47 Typical High $436.52 | Professional | 22 · Increased work | $162.18 | $245.47 | $436.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $257.04 | Professional | 54 · Surgery only | $95.50 | $141.25 | $257.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Facility | None | $263.03 | $263.03 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $407.38 | Professional | None | $109.65 | $223.87 | $407.38 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $169.82 Typical High $660.69 | Facility | None | $74.13 | $169.82 | $660.69 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $309.03 | Professional | None | $147.91 | $239.88 | $309.03 |
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 $77.62 Median $147.91 Typical High $263.03 | Professional | None | $77.62 | $147.91 | $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 $37.15 Median $37.15 Typical High $72.44 | Facility | 52 · Reduced service | $37.15 | $37.15 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $28.84 | Facility | 53 · Discontinued | $14.79 | $14.79 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $21.88 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $14.45 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $14.45 |
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· 20th of 51
$166
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.