How much rates vary
Facilitymedian $105 · 10th to 90th $76 to $263Professionalmedian $170 · 10th to 90th $105 to $282
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 $75.86 Median $75.86 Typical High $104.71 | Facility | None | $75.86 | $75.86 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $107.15 | Professional | None | $74.13 | $93.33 | $107.15 |
BCBS North Dakota Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $281.84 | Professional | None | $134.90 | $190.55 | $281.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $162.18 Median $229.09 Typical High $338.84 | Professional | 22 · Increased work | $162.18 | $229.09 | $338.84 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $288.40 Typical High $426.58 | Professional | 50 · Both sides | $199.53 | $288.40 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $134.90 Typical High $199.53 | Professional | 54 · Surgery only | $93.33 | $134.90 | $199.53 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $213.80 | Facility | None | $186.21 | $186.21 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $295.12 | Professional | None | $93.33 | $181.97 | $295.12 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $263.03 | Facility | None | $75.86 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $562.34 | Professional | None | $109.65 | $181.97 | $562.34 |
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 $81.28 Median $138.04 Typical High $199.53 | Professional | None | $81.28 | $138.04 | $199.53 |
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 $38.02 Median $38.02 Typical High $52.48 | Facility | 52 · Reduced service | $38.02 | $38.02 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $20.89 | Facility | 53 · Discontinued | $15.49 | $15.49 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $15.85 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $10.47 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $46.77 Typical High $53.70 | Professional | 52 · Reduced service | $37.15 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $21.88 | Professional | 53 · Discontinued | $14.79 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $10.96 |
Where North Dakota sits
The same service costs 3.8 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· 7th of 51
$166
AK $309FL $81.28
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.