How much rates vary
Facilitymedian $35 · 10th to 90th $19 to $263Professionalmedian $46 · 10th to 90th $27 to $85
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 $19.50 Median $19.50 Typical High $35.48 | Facility | None | $19.50 | $19.50 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $35.48 Typical High $63.10 | Professional | None | $18.62 | $35.48 | $63.10 |
BCBS North Dakota Setting Professional Modifier None Typical Low $30.90 Median $47.86 Typical High $85.11 | Professional | None | $30.90 | $47.86 | $85.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $37.15 Median $57.54 Typical High $102.33 | Professional | 22 · Increased work | $37.15 | $57.54 | $102.33 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $45.71 Median $72.44 Typical High $125.89 | Professional | 50 · Both sides | $45.71 | $72.44 | $125.89 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $33.11 Typical High $58.88 | Professional | 54 · Surgery only | $21.38 | $33.11 | $58.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $35.48 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $22.91 | $35.48 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $70.79 | Facility | None | $61.66 | $61.66 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $50.12 Typical High $95.50 | Professional | None | $28.18 | $50.12 | $95.50 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $51.29 Typical High $263.03 | Facility | None | $19.50 | $51.29 | $263.03 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $194.98 | Professional | None | $36.31 | $63.10 | $194.98 |
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 $19.95 Median $37.15 Typical High $67.61 | Professional | None | $19.95 | $37.15 | $67.61 |
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 $9.77 Median $9.77 Typical High $17.78 | Facility | 52 · Reduced service | $9.77 | $9.77 | $17.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $7.08 | Facility | 53 · Discontinued | $3.89 | $3.89 | $7.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $5.37 | Facility | 55 · Aftercare only | $2.95 | $2.95 | $5.37 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $3.55 | Facility | 56 · Pre-op care only | $1.95 | $1.95 | $3.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $16.60 Typical High $17.78 | Professional | 52 · Reduced service | $9.77 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $6.61 Typical High $7.08 | Professional | 53 · Discontinued | $3.89 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $5.01 Typical High $5.37 | Professional | 55 · Aftercare only | $2.95 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $3.31 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.95 | $3.31 | $3.55 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 19th of 51
$43.65
AK $91.20VA $23.99
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.