How much rates vary
Facilitymedian $98 · 10th to 90th $38 to $537Professionalmedian $83 · 10th to 90th $46 to $126
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 $38.02 Median $56.23 Typical High $630.96 | Facility | None | $38.02 | $56.23 | $630.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $41.69 | Facility | 54 · Surgery only | $28.84 | $28.84 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $83.18 | Professional | None | $35.48 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $36.31 Typical High $41.69 | Professional | 54 · Surgery only | $26.92 | $36.31 | $41.69 |
BCBS North Dakota Setting Facility Modifier None Typical Low $102.33 Median $371.54 Typical High $512.86 | Facility | None | $102.33 | $371.54 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $125.89 | Professional | None | $70.79 | $91.20 | $125.89 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $85.11 Median $109.65 Typical High $151.36 | Professional | 22 · Increased work | $85.11 | $109.65 | $151.36 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $64.57 Typical High $89.13 | Professional | 54 · Surgery only | $50.12 | $64.57 | $89.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $69.18 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $53.70 | $69.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $104.71 | Facility | None | $91.20 | $91.20 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $141.25 | Professional | None | $48.98 | $89.13 | $141.25 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $114.82 Typical High $467.74 | Facility | None | $38.02 | $114.82 | $467.74 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $295.12 | Professional | None | $57.54 | $104.71 | $295.12 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $109.65 | Professional | None | $39.81 | $72.44 | $109.65 |
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 $19.05 Median $19.05 Typical High $27.54 | Facility | 52 · Reduced service | $19.05 | $19.05 | $27.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $11.22 | Facility | 53 · Discontinued | $7.76 | $7.76 | $11.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $8.32 | Facility | 55 · Aftercare only | $5.75 | $5.75 | $8.32 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $5.62 | Facility | 56 · Pre-op care only | $3.80 | $3.80 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $23.99 Typical High $27.54 | Professional | 52 · Reduced service | $18.20 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $9.55 Typical High $11.22 | Professional | 53 · Discontinued | $7.24 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.24 Typical High $8.32 | Professional | 55 · Aftercare only | $5.37 | $7.24 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.79 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.63 | $4.79 | $5.62 |
Where North Dakota sits
The same service costs 4.2 times more in Alaska than in New York. 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· 6th of 51
$85.11
AK $186NY $44.67
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.