How much rates vary
Facilitymedian $1,549 · 10th to 90th $309 to $2,512Professionalmedian $1,622 · 10th to 90th $417 to $4,786
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 $309.03 Median $1,548.82 Typical High $1,819.70 | Facility | None | $309.03 | $1,548.82 | $1,819.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $1,174.90 | Facility | 54 · Surgery only | $229.09 | $251.19 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $1,202.26 Typical High $2,511.89 | Professional | None | $302.00 | $1,202.26 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $436.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $229.09 | $436.52 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $4,265.80 | Professional | None | $588.84 | $912.01 | $4,265.80 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $1,096.48 Typical High $5,128.61 | Professional | 22 · Increased work | $707.95 | $1,096.48 | $5,128.61 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,348.96 Typical High $6,309.57 | Professional | 50 · Both sides | $870.96 | $1,348.96 | $6,309.57 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $2,951.21 | Professional | 54 · Surgery only | $407.38 | $630.96 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $1,348.96 Typical High $3,890.45 | Professional | None | $363.08 | $1,348.96 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $1,548.82 Typical High $4,677.35 | Facility | None | $309.03 | $1,548.82 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $11,481.54 | Professional | None | $1,698.24 | $4,466.84 | $11,481.54 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,445.44 Typical High $2,951.21 | Professional | None | $331.13 | $1,445.44 | $2,951.21 |
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 $151.36 Median $169.82 Typical High $776.25 | Facility | 52 · Reduced service | $151.36 | $169.82 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $309.03 | Facility | 53 · Discontinued | $61.66 | $67.61 | $309.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $234.42 | Facility | 55 · Aftercare only | $45.71 | $50.12 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $154.88 | Facility | 56 · Pre-op care only | $30.90 | $33.88 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $288.40 Typical High $912.01 | Professional | 52 · Reduced service | $151.36 | $288.40 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $114.82 Typical High $363.08 | Professional | 53 · Discontinued | $61.66 | $114.82 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $87.10 Typical High $275.42 | Professional | 55 · Aftercare only | $45.71 | $87.10 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $57.54 Typical High $181.97 | Professional | 56 · Pre-op care only | $30.90 | $57.54 | $181.97 |
Where North Dakota sits
The same service costs 5.6 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· 19th of 51
$1,585
WI $2,570MD $457
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.