How much rates vary
Facilitymedian $76 · 10th to 90th $55 to $263Professionalmedian $123 · 10th to 90th $76 to $195
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 $54.95 Median $54.95 Typical High $75.86 | Facility | None | $54.95 | $54.95 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $117.49 | Professional | None | $54.95 | $75.86 | $117.49 |
BCBS North Dakota Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $194.98 | Professional | None | $102.33 | $138.04 | $194.98 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $123.03 Median $165.96 Typical High $234.42 | Professional | 22 · Increased work | $123.03 | $165.96 | $234.42 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $208.93 Typical High $295.12 | Professional | 50 · Both sides | $151.36 | $208.93 | $295.12 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $97.72 Typical High $138.04 | Professional | 54 · Surgery only | $70.79 | $97.72 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $104.71 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $75.86 | $104.71 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $154.88 | Facility | None | $134.90 | $134.90 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $213.80 | Professional | None | $75.86 | $134.90 | $213.80 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $112.20 Typical High $263.03 | Facility | None | $54.95 | $112.20 | $263.03 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $446.68 | Professional | None | $77.62 | $147.91 | $446.68 |
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 $57.54 Median $107.15 Typical High $158.49 | Professional | None | $57.54 | $107.15 | $158.49 |
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 $27.54 Median $27.54 Typical High $38.02 | Facility | 52 · Reduced service | $27.54 | $27.54 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $15.14 | Facility | 53 · Discontinued | $10.96 | $10.96 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $11.48 | Facility | 55 · Aftercare only | $8.32 | $8.32 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.59 | Facility | 56 · Pre-op care only | $5.50 | $5.50 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $27.54 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $10.96 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.23 Typical High $11.75 | Professional | 55 · Aftercare only | $8.32 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.50 | $6.92 | $7.94 |
Where North Dakota sits
The same service costs 3.5 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· 8th of 51
$123
AK $219FL $63.10
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.