How much rates vary
Facilitymedian $302 · 10th to 90th $48 to $513Professionalmedian $309 · 10th to 90th $59 to $724
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 $47.86 Median $281.84 Typical High $302.00 | Facility | None | $47.86 | $281.84 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $38.02 Typical High $229.09 | Facility | 54 · Surgery only | $35.48 | $38.02 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $173.78 Typical High $436.52 | Professional | None | $46.77 | $173.78 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $64.57 Typical High $245.47 | Professional | 54 · Surgery only | $35.48 | $64.57 | $245.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $588.84 | Professional | None | $83.18 | $128.82 | $588.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $91.20 Typical High $416.87 | Professional | 54 · Surgery only | $58.88 | $91.20 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $239.88 Typical High $645.65 | Professional | None | $57.54 | $239.88 | $645.65 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $302.00 Typical High $851.14 | Facility | None | $47.86 | $302.00 | $851.14 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $933.25 Typical High $2,290.87 | Professional | None | $323.59 | $933.25 | $2,290.87 |
United Setting Professional Modifier None Typical Low $50.12 Median $245.47 Typical High $645.65 | Professional | None | $50.12 | $245.47 | $645.65 |
10 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 $23.44 Median $25.12 Typical High $151.36 | Facility | 52 · Reduced service | $23.44 | $25.12 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $60.26 | Facility | 53 · Discontinued | $9.55 | $10.00 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.59 Typical High $45.71 | Facility | 55 · Aftercare only | $7.08 | $7.59 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $42.66 Typical High $162.18 | Professional | 52 · Reduced service | $23.44 | $42.66 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $16.98 Typical High $64.57 | Professional | 53 · Discontinued | $9.55 | $16.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.88 Typical High $48.98 | Professional | 55 · Aftercare only | $7.08 | $12.88 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $4.79 | $8.51 | $32.36 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $100.00 Median $154.88 Typical High $707.95 | Professional | 22 · Increased work | $100.00 | $154.88 | $707.95 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $194.98 Typical High $891.25 | Professional | 50 · Both sides | $125.89 | $194.98 | $891.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $97.72 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $63.10 | $97.72 | $446.68 |
Where North Dakota sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 11th of 51
$302
IA $417NE $85.11
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.