How much rates vary
Facilitymedian $240 · 10th to 90th $135 to $417Professionalmedian $407 · 10th to 90th $240 to $661
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 $154.88 Median $239.88 Typical High $239.88 | Facility | None | $154.88 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $181.97 | Facility | 54 · Surgery only | $117.49 | $120.23 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $251.19 | Professional | None | $154.88 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $186.21 | Professional | 54 · Surgery only | $117.49 | $147.91 | $186.21 |
BCBS North Dakota Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $676.08 | Professional | None | $302.00 | $436.52 | $676.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $363.08 Median $524.81 Typical High $812.83 | Professional | 22 · Increased work | $363.08 | $524.81 | $812.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $302.00 Typical High $478.63 | Professional | 54 · Surgery only | $213.80 | $302.00 | $478.63 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $323.59 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $229.09 | $323.59 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Facility | None | $446.68 | $446.68 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $707.95 | Professional | None | $218.78 | $426.58 | $707.95 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $416.87 | Facility | None | $125.89 | $239.88 | $416.87 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $1,174.90 | Professional | None | $251.19 | $467.74 | $1,174.90 |
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 $162.18 Median $295.12 Typical High $489.78 | Professional | None | $162.18 | $295.12 | $489.78 |
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 $77.62 Median $79.43 Typical High $120.23 | Facility | 52 · Reduced service | $77.62 | $79.43 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $48.98 | Facility | 53 · Discontinued | $30.90 | $31.62 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $36.31 | Facility | 55 · Aftercare only | $23.44 | $23.99 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $23.99 | Facility | 56 · Pre-op care only | $15.49 | $15.85 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $97.72 Typical High $123.03 | Professional | 52 · Reduced service | $77.62 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $25.12 |
Where North Dakota sits
The same service costs 3.9 times more in Alaska than in Maryland. 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
$355
AK $692MD $178
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.