How much rates vary
Facilitymedian $562 · 10th to 90th $123 to $776Professionalmedian $589 · 10th to 90th $162 to $1,514
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 $123.03 Median $562.34 Typical High $562.34 | Facility | None | $123.03 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $97.72 Typical High $416.87 | Facility | 54 · Surgery only | $93.33 | $97.72 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $630.96 | Professional | None | $123.03 | $223.87 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $165.96 Typical High $467.74 | Professional | 54 · Surgery only | $93.33 | $165.96 | $467.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $1,318.26 | Professional | None | $213.80 | $338.84 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $257.04 Median $407.38 Typical High $1,584.89 | Professional | 22 · Increased work | $257.04 | $407.38 | $1,584.89 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $933.25 | Professional | 54 · Surgery only | $147.91 | $234.42 | $933.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $251.19 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $158.49 | $251.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $398.11 Typical High $1,348.96 | Professional | None | $147.91 | $398.11 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $371.54 Typical High $954.99 | Facility | None | $123.03 | $371.54 | $954.99 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $2,041.74 Typical High $3,981.07 | Professional | None | $588.84 | $2,041.74 | $3,981.07 |
United Setting Professional Modifier None Typical Low $138.04 Median $512.86 Typical High $1,047.13 | Professional | None | $138.04 | $512.86 | $1,047.13 |
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 $61.66 Median $66.07 Typical High $275.42 | Facility | 52 · Reduced service | $61.66 | $66.07 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $112.20 | Facility | 53 · Discontinued | $25.12 | $26.30 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $83.18 | Facility | 55 · Aftercare only | $18.62 | $19.50 | $83.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $56.23 | Facility | 56 · Pre-op care only | $12.30 | $13.18 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $109.65 Typical High $316.23 | Professional | 52 · Reduced service | $61.66 | $109.65 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $44.67 Typical High $125.89 | Professional | 53 · Discontinued | $25.12 | $44.67 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.11 Typical High $95.50 | Professional | 55 · Aftercare only | $18.62 | $33.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $22.39 Typical High $63.10 | Professional | 56 · Pre-op care only | $12.30 | $22.39 | $63.10 |
Where North Dakota sits
The same service costs 4.0 times more in Wisconsin 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· 12th of 51
$562
WI $851MD $214
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.