How much rates vary
Facilitymedian $182 · 10th to 90th $81 to $1,202Professionalmedian $204 · 10th to 90th $105 to $537
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 $81.28 Median $181.97 Typical High $181.97 | Facility | None | $81.28 | $181.97 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $138.04 | Facility | 54 · Surgery only | $61.66 | $61.66 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $218.78 | Professional | None | $81.28 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $61.66 | $138.04 | $162.18 |
BCBS North Dakota Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $537.03 | Professional | None | $162.18 | $245.47 | $537.03 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $194.98 Median $288.40 Typical High $645.65 | Professional | 22 · Increased work | $194.98 | $288.40 | $645.65 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $371.54 | Professional | 54 · Surgery only | $114.82 | $169.82 | $371.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Facility | None | $346.74 | $346.74 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $218.78 Typical High $501.19 | Professional | None | $102.33 | $218.78 | $501.19 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $245.47 Typical High $1,202.26 | Facility | None | $81.28 | $245.47 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $1,479.11 | Professional | None | $158.49 | $281.84 | $1,479.11 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $81.28 Median $165.96 Typical High $323.59 | Professional | None | $81.28 | $165.96 | $323.59 |
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 $40.74 Median $40.74 Typical High $91.20 | Facility | 52 · Reduced service | $40.74 | $40.74 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $36.31 | Facility | 53 · Discontinued | $16.60 | $16.60 | $36.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $27.54 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $18.20 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $40.74 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $16.60 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $12.30 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.13 | $18.20 | $21.38 |
Where North Dakota sits
The same service costs 4.5 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· 16th of 51
$204
AK $437DC $97.72
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.