How much rates vary
Facilitymedian $85 · 10th to 90th $17 to $263Professionalmedian $85 · 10th to 90th $21 to $182
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 $16.60 Median $16.60 Typical High $85.11 | Facility | None | $16.60 | $16.60 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $87.10 | Professional | None | $15.14 | $20.89 | $87.10 |
BCBS North Dakota Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $181.97 | Professional | None | $26.92 | $40.74 | $181.97 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $31.62 Median $48.98 Typical High $218.78 | Professional | 22 · Increased work | $31.62 | $48.98 | $218.78 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $39.81 Median $61.66 Typical High $269.15 | Professional | 50 · Both sides | $39.81 | $61.66 | $269.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $28.84 Typical High $125.89 | Professional | 54 · Surgery only | $18.62 | $28.84 | $125.89 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.95 Median $30.90 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $19.95 | $30.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $162.18 | Facility | None | $141.25 | $141.25 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $53.70 Typical High $218.78 | Professional | None | $23.44 | $53.70 | $218.78 |
Medica Setting Facility Modifier None Typical Low $16.60 Median $85.11 Typical High $263.03 | Facility | None | $16.60 | $85.11 | $263.03 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $295.12 | Professional | None | $85.11 | $144.54 | $295.12 |
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 $16.98 Median $61.66 Typical High $162.18 | Professional | None | $16.98 | $61.66 | $162.18 |
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 $8.32 Median $8.32 Typical High $42.66 | Facility | 52 · Reduced service | $8.32 | $8.32 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $16.98 | Facility | 53 · Discontinued | $3.39 | $3.39 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $12.88 | Facility | 55 · Aftercare only | $2.51 | $2.51 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $8.51 | Facility | 56 · Pre-op care only | $1.70 | $1.70 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $10.47 Typical High $42.66 | Professional | 52 · Reduced service | $7.94 | $10.47 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.17 Typical High $16.98 | Professional | 53 · Discontinued | $3.16 | $4.17 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $3.09 Typical High $12.88 | Professional | 55 · Aftercare only | $2.40 | $3.09 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.09 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.58 | $2.09 | $8.51 |
Where North Dakota sits
The same service costs 5.9 times more in Iowa 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· 12th of 51
$85.11
IA $117KY $19.95
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.