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 $19.05 Median $19.95 Typical High $331.13 | Facility | None | $19.05 | $19.95 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $457.09 | Professional | None | $19.05 | $19.95 | $457.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $977.24 | Professional | None | $30.90 | $45.71 | $977.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $37.15 Median $54.95 Typical High $1,148.15 | Professional | 22 · Increased work | $37.15 | $54.95 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $32.36 Typical High $676.08 | Professional | 54 · Surgery only | $21.38 | $32.36 | $676.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $34.67 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $22.91 | $34.67 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $851.14 | Facility | None | $741.31 | $741.31 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $1,174.90 | Professional | None | $29.51 | $58.88 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $56.23 Typical High $575.44 | Facility | None | $19.05 | $56.23 | $575.44 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $1,584.89 | Professional | None | $102.33 | $213.80 | $1,584.89 |
United Setting Professional Modifier None Typical Low $13.80 Median $67.61 Typical High $281.84 | Professional | None | $13.80 | $67.61 | $281.84 |
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 $9.55 Median $9.77 Typical High $165.96 | Facility | 52 · Reduced service | $9.55 | $9.77 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $3.98 Typical High $66.07 | Facility | 53 · Discontinued | $3.80 | $3.98 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.82 Median $2.95 Typical High $48.98 | Facility | 55 · Aftercare only | $2.82 | $2.95 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.95 Typical High $33.11 | Facility | 56 · Pre-op care only | $1.91 | $1.95 | $33.11 |
Where North Dakota sits
The same service costs 28.2 times more in Hawaii than in Washington, DC. 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
$178
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.