How much rates vary
Facilitymedian $141 · 10th to 90th $105 to $269Professionalmedian $234 · 10th to 90th $141 to $372
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 $104.71 Median $104.71 Typical High $141.25 | Facility | None | $104.71 | $104.71 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $154.88 | Professional | None | $104.71 | $128.82 | $154.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $229.09 Median $323.59 Typical High $446.68 | Professional | 22 · Increased work | $229.09 | $323.59 | $446.68 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $407.38 Typical High $562.34 | Professional | 50 · Both sides | $288.40 | $407.38 | $562.34 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $190.55 | $263.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $288.40 | Facility | None | $251.19 | $251.19 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $389.05 | Professional | None | $131.83 | $251.19 | $389.05 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $269.15 | Facility | None | $104.71 | $141.25 | $269.15 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $776.25 | Professional | None | $144.54 | $269.15 | $776.25 |
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 $109.65 Median $199.53 Typical High $281.84 | Professional | None | $109.65 | $199.53 | $281.84 |
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 $52.48 Median $52.48 Typical High $70.79 | Facility | 52 · Reduced service | $52.48 | $52.48 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $28.18 | Facility | 53 · Discontinued | $20.89 | $20.89 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $20.89 | Facility | 55 · Aftercare only | $15.85 | $15.85 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $14.13 | Facility | 56 · Pre-op care only | $10.47 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $14.45 |
Where North Dakota sits
The same service costs 4.0 times more in Alaska than in Florida. 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
$234
AK $437FL $110
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.