How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $417Professionalmedian $398 · 10th to 90th $240 to $741
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 $158.49 Median $269.15 Typical High $269.15 | Facility | None | $158.49 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $199.53 | Facility | 54 · Surgery only | $117.49 | $120.23 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $295.12 | Professional | None | $158.49 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $218.78 | Professional | 54 · Surgery only | $117.49 | $147.91 | $218.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $758.58 | Professional | None | $309.03 | $457.09 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $363.08 Median $549.54 Typical High $912.01 | Professional | 22 · Increased work | $363.08 | $549.54 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $316.23 Typical High $524.81 | Professional | 54 · Surgery only | $213.80 | $316.23 | $524.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $338.84 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $229.09 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Facility | None | $501.19 | $501.19 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $794.33 | Professional | None | $208.93 | $436.52 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $457.09 | Facility | None | $125.89 | $251.19 | $457.09 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $1,288.25 | Professional | None | $275.42 | $436.52 | $1,288.25 |
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 $165.96 Median $295.12 Typical High $512.86 | Professional | None | $165.96 | $295.12 | $512.86 |
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 $79.43 Median $79.43 Typical High $134.90 | Facility | 52 · Reduced service | $79.43 | $79.43 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $53.70 | Facility | 53 · Discontinued | $31.62 | $32.36 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $39.81 | Facility | 55 · Aftercare only | $23.44 | $23.99 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $26.92 | Facility | 56 · Pre-op care only | $15.85 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $39.81 Typical High $58.88 | Professional | 53 · Discontinued | $31.62 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $29.51 |
Where North Dakota sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 10th of 51
$363
AK $661MD $182
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.