How much rates vary
Facilitymedian $51 · 10th to 90th $34 to $263Professionalmedian $78 · 10th to 90th $48 to $141
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 $33.88 Median $34.67 Typical High $51.29 | Facility | None | $33.88 | $34.67 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $57.54 | Professional | None | $33.11 | $43.65 | $57.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $144.54 | Professional | None | $61.66 | $91.20 | $144.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $74.13 Median $109.65 Typical High $173.78 | Professional | 22 · Increased work | $74.13 | $109.65 | $173.78 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $134.90 Typical High $218.78 | Professional | 50 · Both sides | $93.33 | $134.90 | $218.78 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $63.10 Typical High $102.33 | Professional | 54 · Surgery only | $43.65 | $63.10 | $102.33 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $67.61 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $46.77 | $67.61 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $112.20 | Facility | None | $97.72 | $97.72 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $154.88 | Professional | None | $48.98 | $87.10 | $154.88 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $58.88 Typical High $263.03 | Facility | None | $33.88 | $58.88 | $263.03 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $257.04 | Professional | None | $53.70 | $102.33 | $257.04 |
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 $35.48 Median $64.57 Typical High $102.33 | Professional | None | $35.48 | $64.57 | $102.33 |
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 $16.98 Median $17.38 Typical High $25.70 | Facility | 52 · Reduced service | $16.98 | $17.38 | $25.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $10.23 | Facility | 53 · Discontinued | $6.76 | $6.92 | $10.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.01 Median $5.13 Typical High $7.76 | Facility | 55 · Aftercare only | $5.01 | $5.13 | $7.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $5.13 | Facility | 56 · Pre-op care only | $3.39 | $3.47 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.51 Typical High $10.72 | Professional | 53 · Discontinued | $6.76 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.46 Typical High $8.13 | Professional | 55 · Aftercare only | $5.01 | $6.46 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.27 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.39 | $4.27 | $5.37 |
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· 9th of 51
$75.86
AK $148KY $39.81
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.