How much rates vary
Facilitymedian $170 · 10th to 90th $78 to $234Professionalmedian $195 · 10th to 90th $98 to $457
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 $77.62 Median $162.18 Typical High $169.82 | Facility | None | $77.62 | $162.18 | $169.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $128.82 | Facility | 54 · Surgery only | $58.88 | $58.88 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $169.82 | Professional | None | $69.18 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $72.44 Typical High $128.82 | Professional | 54 · Surgery only | $50.12 | $72.44 | $128.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $389.05 | Professional | None | $128.82 | $208.93 | $389.05 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $154.88 Median $251.19 Typical High $467.74 | Professional | 22 · Increased work | $154.88 | $251.19 | $467.74 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $316.23 Typical High $575.44 | Professional | 50 · Both sides | $190.55 | $316.23 | $575.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $144.54 Typical High $269.15 | Professional | 54 · Surgery only | $89.13 | $144.54 | $269.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $154.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $95.50 | $154.88 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $194.98 Typical High $407.38 | Professional | None | $89.13 | $194.98 | $407.38 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $169.82 Typical High $288.40 | Facility | None | $77.62 | $169.82 | $288.40 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $616.60 Typical High $1,737.80 | Professional | None | $181.97 | $616.60 | $1,737.80 |
United Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $331.13 | Professional | None | $79.43 | $173.78 | $331.13 |
8 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 $38.90 Median $38.90 Typical High $85.11 | Facility | 52 · Reduced service | $38.90 | $38.90 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $33.88 | Facility | 53 · Discontinued | $15.49 | $15.49 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $25.70 | Facility | 55 · Aftercare only | $11.75 | $11.75 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $16.98 | Facility | 56 · Pre-op care only | $7.76 | $7.76 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $47.86 Typical High $85.11 | Professional | 52 · Reduced service | $33.11 | $47.86 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.05 Typical High $33.88 | Professional | 53 · Discontinued | $13.49 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.45 Typical High $25.70 | Professional | 55 · Aftercare only | $10.00 | $14.45 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.55 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.61 | $9.55 | $16.98 |
Where North Dakota sits
The same service costs 2.6 times more in Wisconsin 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· 13th of 51
$182
WI $309UT $120
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.