How much rates vary
Facilitymedian $98 · 10th to 90th $68 to $269Professionalmedian $155 · 10th to 90th $81 to $257
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 $67.61 Median $95.50 Typical High $102.33 | Facility | None | $67.61 | $95.50 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $144.54 | Professional | None | $67.61 | $87.10 | $144.54 |
BCBS North Dakota Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | None | $128.82 | $177.83 | $263.03 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $154.88 Median $208.93 Typical High $309.03 | Professional | 22 · Increased work | $154.88 | $208.93 | $309.03 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | 50 · Both sides | $194.98 | $263.03 | $389.05 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $123.03 Typical High $181.97 | Professional | 54 · Surgery only | $89.13 | $123.03 | $181.97 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $131.83 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $95.50 | $131.83 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $199.53 | Facility | None | $173.78 | $173.78 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $275.42 | Professional | None | $89.13 | $169.82 | $275.42 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $263.03 | Facility | None | $67.61 | $117.49 | $263.03 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $501.19 | Professional | None | $97.72 | $186.21 | $501.19 |
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 $70.79 Median $128.82 Typical High $190.55 | Professional | None | $70.79 | $128.82 | $190.55 |
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 $33.88 Median $33.88 Typical High $46.77 | Facility | 52 · Reduced service | $33.88 | $33.88 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $19.05 | Facility | 53 · Discontinued | $13.49 | $13.80 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $14.13 | Facility | 55 · Aftercare only | $10.00 | $10.23 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.92 Typical High $9.33 | Facility | 56 · Pre-op care only | $6.76 | $6.92 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $13.49 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $10.00 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.32 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $8.32 | $9.77 |
Where North Dakota sits
The same service costs 3.6 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· 7th of 51
$151
AK $275KY $75.86
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.