How much rates vary
Facilitymedian $155 · 10th to 90th $65 to $214Professionalmedian $166 · 10th to 90th $79 to $427
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 $64.57 Median $147.91 Typical High $154.88 | Facility | None | $64.57 | $147.91 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $117.49 | Facility | 54 · Surgery only | $47.86 | $47.86 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $162.18 | Professional | None | $57.54 | $89.13 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $67.61 Typical High $123.03 | Professional | 54 · Surgery only | $42.66 | $67.61 | $123.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $354.81 | Professional | None | $104.71 | $169.82 | $354.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $125.89 Median $204.17 Typical High $426.58 | Professional | 22 · Increased work | $125.89 | $204.17 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $120.23 Typical High $251.19 | Professional | 54 · Surgery only | $72.44 | $120.23 | $251.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $128.82 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $77.62 | $128.82 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $162.18 Typical High $407.38 | Professional | None | $66.07 | $162.18 | $407.38 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $154.88 Typical High $263.03 | Facility | None | $64.57 | $154.88 | $263.03 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $707.95 Typical High $2,951.21 | Professional | None | $162.18 | $707.95 | $2,951.21 |
United Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $295.12 | Professional | None | $66.07 | $154.88 | $295.12 |
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 $32.36 Median $32.36 Typical High $77.62 | Facility | 52 · Reduced service | $32.36 | $32.36 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $31.62 | Facility | 53 · Discontinued | $12.88 | $12.88 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $23.44 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $15.49 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $44.67 Typical High $81.28 | Professional | 52 · Reduced service | $28.84 | $44.67 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $17.78 Typical High $32.36 | Professional | 53 · Discontinued | $11.48 | $17.78 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.49 Typical High $24.55 | Professional | 55 · Aftercare only | $8.51 | $13.49 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.91 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.75 | $8.91 | $16.22 |
Where North Dakota sits
The same service costs 3.7 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
$158
WI $302MD $81.28
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.