How much rates vary
Facilitymedian $105 · 10th to 90th $62 to $324Professionalmedian $145 · 10th to 90th $76 to $229
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 $61.66 Median $85.11 Typical High $91.20 | Facility | None | $61.66 | $85.11 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $131.83 | Professional | None | $61.66 | $83.18 | $131.83 |
BCBS North Dakota Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $371.54 | Facility | None | $223.87 | $331.13 | $371.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $239.88 | Professional | None | $117.49 | $162.18 | $239.88 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $141.25 Median $194.98 Typical High $281.84 | Professional | 22 · Increased work | $141.25 | $194.98 | $281.84 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $245.47 Typical High $354.81 | Professional | 50 · Both sides | $177.83 | $245.47 | $354.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $81.28 | $114.82 | $165.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $123.03 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $87.10 | $123.03 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $181.97 | Facility | None | $158.49 | $158.49 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $251.19 | Professional | None | $81.28 | $151.36 | $251.19 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $263.03 | Facility | None | $61.66 | $107.15 | $263.03 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $467.74 | Professional | None | $87.10 | $165.96 | $467.74 |
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 $63.10 Median $117.49 Typical High $173.78 | Professional | None | $63.10 | $117.49 | $173.78 |
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 $30.90 Median $31.62 Typical High $42.66 | Facility | 52 · Reduced service | $30.90 | $31.62 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $16.98 | Facility | 53 · Discontinued | $12.30 | $12.59 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $12.88 | Facility | 55 · Aftercare only | $9.12 | $9.55 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $8.51 | Facility | 56 · Pre-op care only | $6.17 | $6.31 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $30.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $12.30 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $9.12 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.17 | $7.76 | $9.12 |
Where North Dakota sits
The same service costs 3.7 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
$138
AK $257KY $69.18
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.