How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $437Professionalmedian $457 · 10th to 90th $269 to $794
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 $177.83 Median $288.40 Typical High $288.40 | Facility | None | $177.83 | $288.40 | $288.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $213.80 | Facility | 54 · Surgery only | $134.90 | $134.90 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $295.12 | Professional | None | $177.83 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $134.90 | $165.96 | $218.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $812.83 | Professional | None | $338.84 | $501.19 | $812.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $407.38 Median $602.56 Typical High $954.99 | Professional | 22 · Increased work | $407.38 | $602.56 | $954.99 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $562.34 | Professional | 54 · Surgery only | $239.88 | $354.81 | $562.34 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $380.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $257.04 | $380.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $478.63 Typical High $851.14 | Professional | None | $229.09 | $478.63 | $851.14 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $489.78 | Facility | None | $125.89 | $257.04 | $489.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $1,621.81 | Professional | None | $295.12 | $537.03 | $1,621.81 |
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 $186.21 Median $338.84 Typical High $549.54 | Professional | None | $186.21 | $338.84 | $549.54 |
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 $89.13 Median $89.13 Typical High $144.54 | Facility | 52 · Reduced service | $89.13 | $89.13 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $57.54 | Facility | 53 · Discontinued | $35.48 | $36.31 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $43.65 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $28.84 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $89.13 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $35.48 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.11 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.39 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.78 | $22.39 | $29.51 |
Where North Dakota sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$398
AK $741KY $186
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.