How much rates vary
Facilitymedian $191 · 10th to 90th $71 to $240Professionalmedian $200 · 10th to 90th $85 to $457
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 $70.79 Median $190.55 Typical High $190.55 | Facility | None | $70.79 | $190.55 | $190.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $52.48 Median $54.95 Typical High $141.25 | Facility | 54 · Surgery only | $52.48 | $54.95 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $181.97 Typical High $281.84 | Professional | None | $70.79 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $95.50 Typical High $151.36 | Professional | 54 · Surgery only | $52.48 | $95.50 | $151.36 |
BCBS North Dakota Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $416.87 | Professional | None | $125.89 | $194.98 | $416.87 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $234.42 Typical High $489.78 | Professional | 22 · Increased work | $147.91 | $234.42 | $489.78 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $134.90 Typical High $288.40 | Professional | 54 · Surgery only | $87.10 | $134.90 | $288.40 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $144.54 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $93.33 | $144.54 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $426.58 | Professional | None | $85.11 | $181.97 | $426.58 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $190.55 Typical High $323.59 | Facility | None | $70.79 | $190.55 | $323.59 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $1,258.93 | Professional | None | $223.87 | $489.78 | $1,258.93 |
United Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $407.38 | Professional | None | $75.86 | $186.21 | $407.38 |
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 $35.48 Median $37.15 Typical High $93.33 | Facility | 52 · Reduced service | $35.48 | $37.15 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $38.02 | Facility | 53 · Discontinued | $14.13 | $14.79 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $28.18 | Facility | 55 · Aftercare only | $10.47 | $10.96 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $19.05 | Facility | 56 · Pre-op care only | $7.08 | $7.41 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $63.10 Typical High $100.00 | Professional | 52 · Reduced service | $35.48 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $25.12 Typical High $39.81 | Professional | 53 · Discontinued | $14.13 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $19.05 Typical High $30.20 | Professional | 55 · Aftercare only | $10.47 | $19.05 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $12.59 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.08 | $12.59 | $19.95 |
Where North Dakota sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 18th of 51
$195
WI $316UT $117
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.