How much rates vary
Facilitymedian $120 · 10th to 90th $85 to $263Professionalmedian $200 · 10th to 90th $115 to $324
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 $85.11 Median $87.10 Typical High $120.23 | Facility | None | $85.11 | $87.10 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $128.82 | Professional | None | $81.28 | $107.15 | $128.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $331.13 | Professional | None | $162.18 | $223.87 | $331.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $194.98 Median $269.15 Typical High $398.11 | Professional | 22 · Increased work | $194.98 | $269.15 | $398.11 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $338.84 Typical High $501.19 | Professional | 50 · Both sides | $245.47 | $338.84 | $501.19 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $114.82 | $158.49 | $234.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $169.82 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $123.03 | $169.82 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $251.19 | Facility | None | $218.78 | $218.78 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $346.74 | Professional | None | $114.82 | $213.80 | $346.74 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $263.03 | Facility | None | $85.11 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $645.65 | Professional | None | $125.89 | $234.42 | $645.65 |
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 $91.20 Median $162.18 Typical High $245.47 | Professional | None | $91.20 | $162.18 | $245.47 |
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 $42.66 Median $43.65 Typical High $60.26 | Facility | 52 · Reduced service | $42.66 | $43.65 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $23.99 | Facility | 53 · Discontinued | $17.38 | $17.38 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $18.20 | Facility | 55 · Aftercare only | $12.88 | $12.88 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $12.02 | Facility | 56 · Pre-op care only | $8.51 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $42.66 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $17.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $12.88 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.51 | $10.72 | $12.30 |
Where North Dakota sits
The same service costs 3.6 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· 7th of 51
$195
AK $355KY $97.72
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.