How much rates vary
Facilitymedian $135 · 10th to 90th $42 to $275Professionalmedian $102 · 10th to 90th $60 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 $41.69 Median $81.28 Typical High $234.42 | Facility | None | $41.69 | $81.28 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $109.65 | Professional | None | $41.69 | $74.13 | $109.65 |
BCBS North Dakota Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $354.81 | Facility | None | $151.36 | $213.80 | $354.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $229.09 | Professional | None | $75.86 | $112.20 | $229.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $91.20 Median $134.90 Typical High $275.42 | Professional | 22 · Increased work | $91.20 | $134.90 | $275.42 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $169.82 Typical High $346.74 | Professional | 50 · Both sides | $112.20 | $169.82 | $346.74 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $79.43 Typical High $162.18 | Professional | 54 · Surgery only | $52.48 | $79.43 | $162.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $85.11 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $56.23 | $85.11 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Facility | None | $147.91 | $147.91 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $229.09 | Professional | None | $60.26 | $107.15 | $229.09 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $123.03 Typical High $263.03 | Facility | None | $41.69 | $123.03 | $263.03 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $331.13 | Professional | None | $83.18 | $165.96 | $331.13 |
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 $43.65 Median $104.71 Typical High $177.83 | Professional | None | $43.65 | $104.71 | $177.83 |
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 $20.42 Median $20.42 Typical High $40.74 | Facility | 52 · Reduced service | $20.42 | $20.42 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $16.22 | Facility | 53 · Discontinued | $8.32 | $8.32 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $12.02 | Facility | 55 · Aftercare only | $6.17 | $6.17 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $8.13 | Facility | 56 · Pre-op care only | $4.17 | $4.17 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $28.84 Typical High $42.66 | Professional | 52 · Reduced service | $20.42 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.48 Typical High $16.98 | Professional | 53 · Discontinued | $8.32 | $11.48 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.71 Typical High $12.88 | Professional | 55 · Aftercare only | $6.17 | $8.71 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.75 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.17 | $5.75 | $8.51 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 11th of 51
$105
AK $214VA $56.23
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.