How much rates vary
Facilitymedian $186 · 10th to 90th $95 to $2,570Professionalmedian $234 · 10th to 90th $129 to $550
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 $95.50 Median $186.21 Typical High $186.21 | Facility | None | $95.50 | $186.21 | $186.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $141.25 | Facility | 54 · Surgery only | $72.44 | $72.44 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $223.87 | Professional | None | $95.50 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $72.44 | $141.25 | $169.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $549.54 | Professional | None | $190.55 | $288.40 | $549.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $229.09 Median $346.74 Typical High $660.69 | Professional | 22 · Increased work | $229.09 | $346.74 | $660.69 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $204.17 Typical High $389.05 | Professional | 54 · Surgery only | $134.90 | $204.17 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $218.78 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $144.54 | $218.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $524.81 | Professional | None | $123.03 | $257.04 | $524.81 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $295.12 Typical High $2,630.27 | Facility | None | $95.50 | $295.12 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $1,548.82 | Professional | None | $173.78 | $302.00 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $93.33 Median $190.55 Typical High $338.84 | Professional | None | $93.33 | $190.55 | $338.84 |
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 $47.86 Median $47.86 Typical High $93.33 | Facility | 52 · Reduced service | $47.86 | $47.86 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $37.15 | Facility | 53 · Discontinued | $19.50 | $19.50 | $37.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $28.18 | Facility | 55 · Aftercare only | $14.45 | $14.45 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $18.62 | Facility | 56 · Pre-op care only | $9.55 | $9.55 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $47.86 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $37.15 Typical High $44.67 | Professional | 53 · Discontinued | $19.50 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $14.45 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $18.62 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.55 | $18.62 | $22.39 |
Where North Dakota sits
The same service costs 4.0 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· 13th of 51
$234
AK $468DC $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.