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 $151.36 Median $173.78 Typical High $173.78 | Facility | None | $151.36 | $173.78 | $173.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $120.23 Typical High $131.83 | Facility | 54 · Surgery only | $114.82 | $120.23 | $131.83 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $112.20 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $107.15 | $112.20 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | None | $151.36 | $162.18 | $190.55 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $457.09 | Professional | None | $288.40 | $354.81 | $457.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $338.84 Median $426.58 Typical High $549.54 | Professional | 22 · Increased work | $338.84 | $426.58 | $549.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $251.19 | $316.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $269.15 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $213.80 | $269.15 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $549.54 | Professional | None | $239.88 | $363.08 | $549.54 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $269.15 Typical High $1,202.26 | Facility | None | $151.36 | $269.15 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $380.19 | Professional | None | $173.78 | $302.00 | $380.19 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $346.74 | Professional | None | $158.49 | $281.84 | $346.74 |
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 $75.86 Median $81.28 Typical High $87.10 | Facility | 52 · Reduced service | $75.86 | $81.28 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $34.67 | Facility | 53 · Discontinued | $30.90 | $32.36 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $26.30 | Facility | 55 · Aftercare only | $22.91 | $24.55 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $17.38 | Facility | 56 · Pre-op care only | $15.14 | $16.22 | $17.38 |
Where North Dakota sits
The same service costs 4.6 times more in Alaska 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· 7th of 51
$331
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.