How much rates vary
Facilitymedian $135 · 10th to 90th $60 to $708Professionalmedian $126 · 10th to 90th $76 to $245
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 $60.26 Median $93.33 Typical High $1,412.54 | Facility | None | $60.26 | $93.33 | $1,412.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $70.79 | Facility | 54 · Surgery only | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $123.03 | Professional | None | $56.23 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $44.67 | $57.54 | $74.13 |
BCBS North Dakota Setting Facility Modifier None Typical Low $389.05 Median $407.38 Typical High $588.84 | Facility | None | $389.05 | $407.38 | $588.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $251.19 | Professional | None | $100.00 | $154.88 | $251.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $120.23 Median $190.55 Typical High $302.00 | Professional | 22 · Increased work | $120.23 | $190.55 | $302.00 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $239.88 Typical High $380.19 | Professional | 50 · Both sides | $151.36 | $239.88 | $380.19 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $107.15 Typical High $177.83 | Professional | 54 · Surgery only | $69.18 | $107.15 | $177.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $114.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $74.13 | $114.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Facility | None | $169.82 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $269.15 | Professional | None | $85.11 | $151.36 | $269.15 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $125.89 Typical High $269.15 | Facility | None | $60.26 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $436.52 | Professional | None | $97.72 | $181.97 | $436.52 |
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 $63.10 Median $114.82 Typical High $181.97 | Professional | None | $63.10 | $114.82 | $181.97 |
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 $30.20 Median $30.20 Typical High $46.77 | Facility | 52 · Reduced service | $30.20 | $30.20 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $19.05 | Facility | 53 · Discontinued | $12.02 | $12.02 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $14.13 | Facility | 55 · Aftercare only | $8.91 | $8.91 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $9.33 | Facility | 56 · Pre-op care only | $6.03 | $6.03 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $30.20 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $12.02 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.59 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.03 | $7.59 | $10.00 |
Where North Dakota sits
The same service costs 3.7 times more in Alaska 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
$126
AK $275KY $74.13
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.