How much rates vary
Facilitymedian $251 · 10th to 90th $83 to $468Professionalmedian $347 · 10th to 90th $110 to $871
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 $83.18 Median $316.23 Typical High $346.74 | Facility | None | $83.18 | $316.23 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $257.04 | Facility | 54 · Surgery only | $63.10 | $63.10 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $302.00 Typical High $426.58 | Professional | None | $83.18 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $63.10 | $239.88 | $257.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $870.96 | Professional | None | $165.96 | $251.19 | $870.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $199.53 Median $302.00 Typical High $1,047.13 | Professional | 22 · Increased work | $199.53 | $302.00 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $616.60 | Professional | 54 · Surgery only | $114.82 | $173.78 | $616.60 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $186.21 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $123.03 | $186.21 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Facility | None | $575.44 | $575.44 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $281.84 Typical High $831.76 | Professional | None | $107.15 | $281.84 | $831.76 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $251.19 Typical High $588.84 | Facility | None | $83.18 | $251.19 | $588.84 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $2,454.71 | Professional | None | $302.00 | $616.60 | $2,454.71 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $87.10 Median $257.04 Typical High $660.69 | Professional | None | $87.10 | $257.04 | $660.69 |
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 $41.69 Median $41.69 Typical High $169.82 | Facility | 52 · Reduced service | $41.69 | $41.69 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $69.18 | Facility | 53 · Discontinued | $16.60 | $16.60 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $51.29 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $34.67 | Facility | 56 · Pre-op care only | $8.32 | $8.32 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $41.69 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $63.10 Typical High $69.18 | Professional | 53 · Discontinued | $16.60 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $12.59 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $31.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $8.32 | $31.62 | $34.67 |
Where North Dakota sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 13th of 51
$347
WI $479DC $100
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.