How much rates vary
Facilitymedian $186 · 10th to 90th $76 to $380Professionalmedian $200 · 10th to 90th $93 to $513
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 $75.86 Median $186.21 Typical High $549.54 | Facility | None | $75.86 | $186.21 | $549.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $141.25 | Facility | 54 · Surgery only | $56.23 | $56.23 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $173.78 Typical High $331.13 | Professional | None | $67.61 | $173.78 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $74.13 Typical High $147.91 | Professional | 54 · Surgery only | $50.12 | $74.13 | $147.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $457.09 | Professional | None | $123.03 | $199.53 | $457.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $239.88 Typical High $549.54 | Professional | 22 · Increased work | $147.91 | $239.88 | $549.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $302.00 Typical High $691.83 | Professional | 50 · Both sides | $181.97 | $302.00 | $691.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $141.25 Typical High $316.23 | Professional | 54 · Surgery only | $85.11 | $141.25 | $316.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $151.36 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $91.20 | $151.36 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $194.98 Typical High $478.63 | Professional | None | $81.28 | $194.98 | $478.63 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $380.19 | Facility | None | $75.86 | $186.21 | $380.19 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $524.81 Typical High $2,511.89 | Professional | None | $190.55 | $524.81 | $2,511.89 |
United Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $346.74 | Professional | None | $77.62 | $190.55 | $346.74 |
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 $37.15 Median $37.15 Typical High $93.33 | Facility | 52 · Reduced service | $37.15 | $37.15 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $37.15 | Facility | 53 · Discontinued | $15.14 | $15.14 | $37.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $28.18 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $18.62 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $48.98 Typical High $97.72 | Professional | 52 · Reduced service | $33.11 | $48.98 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.50 Typical High $38.90 | Professional | 53 · Discontinued | $13.49 | $19.50 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.79 Typical High $29.51 | Professional | 55 · Aftercare only | $10.00 | $14.79 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.77 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.76 | $9.77 | $19.50 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 16th of 51
$191
AK $363VA $95.50
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.