How much rates vary
Facilitymedian $182 · 10th to 90th $68 to $269Professionalmedian $186 · 10th to 90th $83 to $501
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 $67.61 Median $181.97 Typical High $181.97 | Facility | None | $67.61 | $181.97 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $138.04 | Facility | 54 · Surgery only | $51.29 | $51.29 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $199.53 | Professional | None | $60.26 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $67.61 Typical High $144.54 | Professional | 54 · Surgery only | $45.71 | $67.61 | $144.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $457.09 | Professional | None | $112.20 | $181.97 | $457.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $128.82 Typical High $316.23 | Professional | 54 · Surgery only | $77.62 | $128.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $186.21 Typical High $489.78 | Professional | None | $74.13 | $186.21 | $489.78 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $181.97 Typical High $309.03 | Facility | None | $67.61 | $181.97 | $309.03 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $602.56 Typical High $2,691.53 | Professional | None | $186.21 | $602.56 | $2,691.53 |
United Setting Professional Modifier None Typical Low $70.79 Median $173.78 Typical High $346.74 | Professional | None | $70.79 | $173.78 | $346.74 |
11 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 $33.88 Median $33.88 Typical High $91.20 | Facility | 52 · Reduced service | $33.88 | $33.88 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $36.31 | Facility | 53 · Discontinued | $13.49 | $13.49 | $36.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $27.54 | Facility | 55 · Aftercare only | $10.23 | $10.23 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $18.20 | Facility | 56 · Pre-op care only | $6.76 | $6.76 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $44.67 Typical High $95.50 | Professional | 52 · Reduced service | $30.90 | $44.67 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.78 Typical High $38.02 | Professional | 53 · Discontinued | $12.30 | $17.78 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.49 Typical High $28.84 | Professional | 55 · Aftercare only | $9.12 | $13.49 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $19.05 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $134.90 Median $218.78 Typical High $549.54 | Professional | 22 · Increased work | $134.90 | $218.78 | $549.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $275.42 Typical High $676.08 | Professional | 50 · Both sides | $165.96 | $275.42 | $676.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $138.04 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $83.18 | $138.04 | $338.84 |
Where North Dakota sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 17th of 51
$186
NC $302IN $85.11
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.