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 $208.93 Median $213.80 Typical High $229.09 | Facility | None | $208.93 | $213.80 | $229.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | 54 · Surgery only | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $257.04 | Professional | None | $190.55 | $213.80 | $257.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $588.84 | Professional | None | $389.05 | $489.78 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $588.84 Typical High $707.95 | Professional | 22 · Increased work | $467.74 | $588.84 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $467.74 | Facility | None | $407.38 | $407.38 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $741.31 | Professional | None | $309.03 | $457.09 | $741.31 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $2,630.27 | Facility | None | $208.93 | $389.05 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $501.19 | Professional | None | $245.47 | $398.11 | $501.19 |
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 $223.87 Median $398.11 Typical High $467.74 | Professional | None | $223.87 | $398.11 | $467.74 |
5 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 $104.71 Median $104.71 Typical High $114.82 | Facility | 52 · Reduced service | $104.71 | $104.71 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $46.77 | Facility | 53 · Discontinued | $41.69 | $41.69 | $46.77 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $34.67 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $22.91 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $162.18 |
Where North Dakota sits
The same service costs 4.6 times more in Oklahoma than in Utah. 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
$427
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.