How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $479Professionalmedian $468 · 10th to 90th $282 to $851
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 $186.21 Median $309.03 Typical High $309.03 | Facility | None | $186.21 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $229.09 | Facility | 54 · Surgery only | $138.04 | $141.25 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $316.23 | Professional | None | $186.21 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $173.78 Typical High $234.42 | Professional | 54 · Surgery only | $138.04 | $173.78 | $234.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $870.96 | Professional | None | $354.81 | $537.03 | $870.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $426.58 Median $630.96 Typical High $1,047.13 | Professional | 22 · Increased work | $426.58 | $630.96 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $371.54 Typical High $602.56 | Professional | 54 · Surgery only | $251.19 | $371.54 | $602.56 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $398.11 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $269.15 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Facility | None | $575.44 | $575.44 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $501.19 Typical High $912.01 | Professional | None | $229.09 | $501.19 | $912.01 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $524.81 | Facility | None | $125.89 | $251.19 | $524.81 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $1,380.38 | Professional | None | $316.23 | $524.81 | $1,380.38 |
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 $194.98 Median $346.74 Typical High $588.84 | Professional | None | $194.98 | $346.74 | $588.84 |
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 $93.33 Median $93.33 Typical High $154.88 | Facility | 52 · Reduced service | $93.33 | $93.33 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $61.66 | Facility | 53 · Discontinued | $37.15 | $38.02 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $45.71 | Facility | 55 · Aftercare only | $27.54 | $28.18 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $30.90 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $63.10 | Professional | 53 · Discontinued | $37.15 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $27.54 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $31.62 |
Where North Dakota sits
The same service costs 3.8 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
$417
AK $759MD $200
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.