How much rates vary
Facilitymedian $98 · 10th to 90th $69 to $263Professionalmedian $158 · 10th to 90th $98 to $269
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 $69.18 Median $97.72 Typical High $97.72 | Facility | None | $69.18 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $52.48 Typical High $72.44 | Facility | 54 · Surgery only | $51.29 | $52.48 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $100.00 | Professional | None | $69.18 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $64.57 Typical High $74.13 | Professional | 54 · Surgery only | $51.29 | $64.57 | $74.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $269.15 | Professional | None | $134.90 | $181.97 | $269.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $162.18 Median $218.78 Typical High $323.59 | Professional | 22 · Increased work | $162.18 | $218.78 | $323.59 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $125.89 Typical High $190.55 | Professional | 54 · Surgery only | $93.33 | $125.89 | $190.55 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $134.90 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $100.00 | $134.90 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $204.17 | Facility | None | $177.83 | $177.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $281.84 | Professional | None | $81.28 | $173.78 | $281.84 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $120.23 Typical High $263.03 | Facility | None | $69.18 | $120.23 | $263.03 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $512.86 | Professional | None | $100.00 | $147.91 | $512.86 |
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 $72.44 Median $112.20 Typical High $186.21 | Professional | None | $72.44 | $112.20 | $186.21 |
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 $34.67 Median $34.67 Typical High $48.98 | Facility | 52 · Reduced service | $34.67 | $34.67 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $19.50 | Facility | 53 · Discontinued | $13.80 | $14.13 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.47 Typical High $14.45 | Facility | 55 · Aftercare only | $10.23 | $10.47 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $9.77 | Facility | 56 · Pre-op care only | $6.92 | $7.08 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $42.66 Typical High $50.12 | Professional | 52 · Reduced service | $34.67 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $13.80 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.88 Typical High $15.14 | Professional | 55 · Aftercare only | $10.23 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $10.00 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 6th of 51
$158
AK $282FL $74.13
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.