How much rates vary
Facilitymedian $120 · 10th to 90th $81 to $263Professionalmedian $195 · 10th to 90th $120 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 $81.28 Median $81.28 Typical High $120.23 | Facility | None | $81.28 | $81.28 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $123.03 | Professional | None | $79.43 | $102.33 | $123.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $331.13 | Professional | None | $144.54 | $208.93 | $331.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $173.78 Median $251.19 Typical High $398.11 | Professional | 22 · Increased work | $173.78 | $251.19 | $398.11 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $316.23 Typical High $489.78 | Professional | 50 · Both sides | $218.78 | $316.23 | $489.78 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $100.00 | $147.91 | $229.09 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $107.15 | $158.49 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $251.19 | Facility | None | $213.80 | $213.80 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $338.84 | Professional | None | $112.20 | $208.93 | $338.84 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $263.03 | Facility | None | $81.28 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $602.56 | Professional | None | $125.89 | $229.09 | $602.56 |
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 $87.10 Median $154.88 Typical High $239.88 | Professional | None | $87.10 | $154.88 | $239.88 |
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 $40.74 Median $40.74 Typical High $60.26 | Facility | 52 · Reduced service | $40.74 | $40.74 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $23.99 | Facility | 53 · Discontinued | $16.22 | $16.22 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $18.20 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $12.02 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $15.85 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $10.23 | $12.30 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$182
AK $339MD $95.50
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.