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 $125.89 Median $208.93 Typical High $208.93 | Facility | None | $125.89 | $208.93 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $97.72 Typical High $154.88 | Facility | 54 · Surgery only | $93.33 | $97.72 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $91.20 Typical High $144.54 | Facility | 78 · Unplanned return to OR | $87.10 | $91.20 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $234.42 | Professional | None | $125.89 | $199.53 | $234.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $512.86 | Professional | None | $239.88 | $331.13 | $512.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $288.40 Median $398.11 Typical High $616.60 | Professional | 22 · Increased work | $288.40 | $398.11 | $616.60 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $501.19 Typical High $758.58 | Professional | 50 · Both sides | $363.08 | $501.19 | $758.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $234.42 Typical High $354.81 | Professional | 54 · Surgery only | $165.96 | $234.42 | $354.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $251.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $177.83 | $251.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $660.69 | Professional | None | $218.78 | $346.74 | $660.69 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $302.00 Typical High $1,202.26 | Facility | None | $125.89 | $302.00 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $446.68 | Professional | None | $208.93 | $380.19 | $446.68 |
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 $128.82 Median $239.88 Typical High $416.87 | Professional | None | $128.82 | $239.88 | $416.87 |
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 $63.10 Median $64.57 Typical High $104.71 | Facility | 52 · Reduced service | $63.10 | $64.57 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $41.69 | Facility | 53 · Discontinued | $25.12 | $25.70 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $30.90 | Facility | 55 · Aftercare only | $19.05 | $19.50 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $20.89 | Facility | 56 · Pre-op care only | $12.59 | $12.88 | $20.89 |
Where North Dakota sits
The same service costs 3.9 times more in Oklahoma 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· 13th of 51
$295
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.