How much rates vary
Facilitymedian $200 · 10th to 90th $83 to $1,660Professionalmedian $200 · 10th to 90th $107 to $417
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 $83.18 Median $162.18 Typical High $1,995.26 | Facility | None | $83.18 | $162.18 | $1,995.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $123.03 | Facility | 54 · Surgery only | $63.10 | $63.10 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $162.18 Typical High $251.19 | Professional | None | $67.61 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $79.43 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $79.43 | $125.89 |
BCBS North Dakota Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $1,380.38 | Facility | None | $134.90 | $223.87 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $426.58 | Professional | None | $147.91 | $218.78 | $426.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $177.83 Median $263.03 Typical High $512.86 | Professional | 22 · Increased work | $177.83 | $263.03 | $512.86 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $331.13 Typical High $630.96 | Professional | 50 · Both sides | $218.78 | $331.13 | $630.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $154.88 Typical High $295.12 | Professional | 54 · Surgery only | $102.33 | $154.88 | $295.12 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $165.96 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $109.65 | $165.96 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $331.13 | Facility | None | $288.40 | $288.40 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $457.09 | Professional | None | $123.03 | $223.87 | $457.09 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $162.18 Typical High $691.83 | Facility | None | $83.18 | $162.18 | $691.83 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $676.08 | Professional | None | $165.96 | $302.00 | $676.08 |
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 $87.10 Median $169.82 Typical High $323.59 | Professional | None | $87.10 | $169.82 | $323.59 |
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 $41.69 Median $41.69 Typical High $81.28 | Facility | 52 · Reduced service | $41.69 | $41.69 | $81.28 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $33.11 | Facility | 53 · Discontinued | $16.60 | $16.60 | $33.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $24.55 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $16.22 | Facility | 56 · Pre-op care only | $8.32 | $8.32 | $16.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $53.70 Typical High $83.18 | Professional | 52 · Reduced service | $41.69 | $53.70 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $33.88 | Professional | 53 · Discontinued | $16.60 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $16.98 |
Where North Dakota sits
The same service costs 3.9 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· 14th of 51
$200
AK $417VA $107
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.