How much rates vary
Facilitymedian $166 · 10th to 90th $39 to $302Professionalmedian $100 · 10th to 90th $54 to $186
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 $38.90 Median $64.57 Typical High $363.08 | Facility | None | $38.90 | $64.57 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $97.72 | Professional | None | $38.90 | $64.57 | $97.72 |
BCBS North Dakota Setting Facility Modifier None Typical Low $144.54 Median $190.55 Typical High $331.13 | Facility | None | $144.54 | $190.55 | $331.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $186.21 | Professional | None | $81.28 | $117.49 | $186.21 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $97.72 Median $141.25 Typical High $223.87 | Professional | 22 · Increased work | $97.72 | $141.25 | $223.87 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $173.78 Typical High $281.84 | Professional | 50 · Both sides | $123.03 | $173.78 | $281.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $81.28 Typical High $131.83 | Professional | 54 · Surgery only | $57.54 | $81.28 | $131.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $87.10 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $61.66 | $87.10 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Facility | None | $120.23 | $120.23 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $109.65 Typical High $190.55 | Professional | None | $60.26 | $109.65 | $190.55 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $117.49 Typical High $269.15 | Facility | None | $38.90 | $117.49 | $269.15 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $302.00 | Professional | None | $66.07 | $125.89 | $302.00 |
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 $40.74 Median $77.62 Typical High $128.82 | Professional | None | $40.74 | $77.62 | $128.82 |
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 $19.50 Median $20.42 Typical High $32.36 | Facility | 52 · Reduced service | $19.50 | $20.42 | $32.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $12.88 | Facility | 53 · Discontinued | $7.76 | $8.13 | $12.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.89 Median $6.17 Typical High $9.55 | Facility | 55 · Aftercare only | $5.89 | $6.17 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $6.46 | Facility | 56 · Pre-op care only | $3.89 | $4.07 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $24.55 Typical High $35.48 | Professional | 52 · Reduced service | $19.50 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.77 Typical High $14.13 | Professional | 53 · Discontinued | $7.76 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.41 Typical High $10.72 | Professional | 55 · Aftercare only | $5.89 | $7.41 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.90 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.89 | $4.90 | $7.08 |
Where North Dakota sits
The same service costs 4.0 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· 5th of 51
$105
AK $195KY $48.98
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.