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 $45.71 Median $125.89 Typical High $125.89 | Facility | None | $45.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $125.89 Typical High $125.89 | Professional | None | $45.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $34.67 | $95.50 | $95.50 |
BCBS North Dakota Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $562.34 | Professional | None | $114.82 | $177.83 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $138.04 Median $213.80 Typical High $676.08 | Professional | 22 · Increased work | $138.04 | $213.80 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $123.03 Typical High $398.11 | Professional | 54 · Surgery only | $81.28 | $123.03 | $398.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $131.83 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $87.10 | $131.83 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $125.89 Typical High $269.15 | Facility | None | $45.71 | $125.89 | $269.15 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
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 Professional Modifier 52 · Reduced service Typical Low $22.91 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $22.91 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $9.12 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $6.92 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.57 | $12.59 | $12.59 |
Where North Dakota sits
The same service costs 16.6 times more in California than in Texas. 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
$148
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.