How much rates vary
Facilitymedian $126 · 10th to 90th $48 to $759Professionalmedian $126 · 10th to 90th $58 to $347
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 $47.86 Median $125.89 Typical High $125.89 | Facility | None | $47.86 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $93.33 | Facility | 54 · Surgery only | $35.48 | $35.48 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $114.82 Typical High $218.78 | Professional | None | $47.86 | $114.82 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $89.13 Typical High $100.00 | Professional | 54 · Surgery only | $35.48 | $89.13 | $100.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $346.74 | Professional | None | $89.13 | $138.04 | $346.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $107.15 Median $165.96 Typical High $416.87 | Professional | 22 · Increased work | $107.15 | $165.96 | $416.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $97.72 Typical High $245.47 | Professional | 54 · Surgery only | $63.10 | $97.72 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $104.71 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $67.61 | $104.71 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $331.13 | Professional | None | $64.57 | $134.90 | $331.13 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $144.54 Typical High $660.69 | Facility | None | $47.86 | $144.54 | $660.69 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $954.99 | Professional | None | $104.71 | $223.87 | $954.99 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $47.86 Median $109.65 Typical High $245.47 | Professional | None | $47.86 | $109.65 | $245.47 |
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 $23.99 Median $23.99 Typical High $63.10 | Facility | 52 · Reduced service | $23.99 | $23.99 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $25.12 | Facility | 53 · Discontinued | $9.55 | $9.55 | $25.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $18.62 | Facility | 55 · Aftercare only | $7.08 | $7.08 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $12.59 | Facility | 56 · Pre-op care only | $4.79 | $4.79 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $23.99 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $9.55 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $17.78 Typical High $19.95 | Professional | 55 · Aftercare only | $7.08 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $11.75 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.79 | $11.75 | $13.49 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska 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· 17th of 51
$126
AK $224DC $63.10
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.