How much rates vary
Facilitymedian $1,259 · 10th to 90th $275 to $1,698Professionalmedian $1,380 · 10th to 90th $380 to $3,388
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 $275.42 Median $1,258.93 Typical High $1,258.93 | Facility | None | $275.42 | $1,258.93 | $1,258.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $954.99 | Facility | 54 · Surgery only | $204.17 | $218.78 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,071.52 Typical High $1,905.46 | Professional | None | $275.42 | $1,071.52 | $1,905.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $389.05 Typical High $1,047.13 | Professional | 54 · Surgery only | $204.17 | $389.05 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $3,090.30 | Professional | None | $501.19 | $794.33 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $602.56 Median $933.25 Typical High $3,715.35 | Professional | 22 · Increased work | $602.56 | $933.25 | $3,715.35 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,174.90 Typical High $4,570.88 | Professional | 50 · Both sides | $758.58 | $1,174.90 | $4,570.88 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $549.54 Typical High $2,137.96 | Professional | 54 · Surgery only | $354.81 | $549.54 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $588.84 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $380.19 | $588.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $1,096.48 Typical High $3,019.95 | Professional | None | $338.84 | $1,096.48 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $812.83 Typical High $2,137.96 | Facility | None | $275.42 | $812.83 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $4,073.80 Typical High $8,912.51 | Professional | None | $1,380.38 | $4,073.80 | $8,912.51 |
United Setting Professional Modifier None Typical Low $302.00 Median $1,174.90 Typical High $2,454.71 | Professional | None | $302.00 | $1,174.90 | $2,454.71 |
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 $138.04 Median $147.91 Typical High $630.96 | Facility | 52 · Reduced service | $138.04 | $147.91 | $630.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $251.19 | Facility | 53 · Discontinued | $54.95 | $58.88 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $190.55 | Facility | 55 · Aftercare only | $40.74 | $44.67 | $190.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $125.89 | Facility | 56 · Pre-op care only | $27.54 | $29.51 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $257.04 Typical High $691.83 | Professional | 52 · Reduced service | $138.04 | $257.04 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $102.33 Typical High $275.42 | Professional | 53 · Discontinued | $54.95 | $102.33 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $77.62 Typical High $208.93 | Professional | 55 · Aftercare only | $40.74 | $77.62 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $51.29 Typical High $138.04 | Professional | 56 · Pre-op care only | $27.54 | $51.29 | $138.04 |
Where North Dakota sits
The same service costs 5.1 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· 21st of 51
$1,288
WI $2,042MD $398
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.