How much rates vary
Facilitymedian $135 · 10th to 90th $79 to $501Professionalmedian $174 · 10th to 90th $102 to $251
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 $79.43 Median $102.33 Typical High $501.19 | Facility | None | $79.43 | $102.33 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $77.62 | Facility | 54 · Surgery only | $60.26 | $60.26 | $77.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $56.23 Typical High $72.44 | Facility | 78 · Unplanned return to OR | $56.23 | $56.23 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $151.36 | Professional | None | $77.62 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $75.86 Typical High $79.43 | Professional | 54 · Surgery only | $60.26 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $70.79 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $56.23 | $70.79 | $74.13 |
BCBS North Dakota Setting Facility Modifier None Typical Low $263.03 Median $331.13 Typical High $346.74 | Facility | None | $263.03 | $331.13 | $346.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $251.19 | Professional | None | $141.25 | $190.55 | $251.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $169.82 Median $229.09 Typical High $302.00 | Professional | 22 · Increased work | $169.82 | $229.09 | $302.00 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $288.40 Typical High $380.19 | Professional | 50 · Both sides | $213.80 | $288.40 | $380.19 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $131.83 Typical High $177.83 | Professional | 54 · Surgery only | $100.00 | $131.83 | $177.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $141.25 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $107.15 | $141.25 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $208.93 | Facility | None | $181.97 | $181.97 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $288.40 | Professional | None | $120.23 | $194.98 | $288.40 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $134.90 Typical High $269.15 | Facility | None | $79.43 | $134.90 | $269.15 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $218.78 Typical High $616.60 | Professional | None | $104.71 | $218.78 | $616.60 |
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 $81.28 Median $154.88 Typical High $234.42 | Professional | None | $81.28 | $154.88 | $234.42 |
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 $39.81 Median $40.74 Typical High $51.29 | Facility | 52 · Reduced service | $39.81 | $40.74 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $20.42 | Facility | 53 · Discontinued | $15.85 | $16.22 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $15.49 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $10.23 | Facility | 56 · Pre-op care only | $7.94 | $8.13 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $39.81 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $15.85 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.94 | $10.23 | $10.72 |
Where North Dakota sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 9th of 51
$174
AK $324FL $83.18
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.