How much rates vary
Facilitymedian $204 · 10th to 90th $110 to $1,202Professionalmedian $257 · 10th to 90th $145 to $562
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 $109.65 Median $204.17 Typical High $204.17 | Facility | None | $109.65 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $151.36 | Facility | 54 · Surgery only | $83.18 | $83.18 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $234.42 | Professional | None | $109.65 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $83.18 | $151.36 | $173.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $562.34 | Professional | None | $204.17 | $316.23 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $380.19 Typical High $676.08 | Professional | 22 · Increased work | $245.47 | $380.19 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $398.11 | Professional | 54 · Surgery only | $144.54 | $218.78 | $398.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $234.42 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $154.88 | $234.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $288.40 Typical High $549.54 | Professional | None | $138.04 | $288.40 | $549.54 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $309.03 Typical High $1,202.26 | Facility | None | $109.65 | $309.03 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $1,621.81 | Professional | None | $177.83 | $323.59 | $1,621.81 |
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 $109.65 Median $208.93 Typical High $363.08 | Professional | None | $109.65 | $208.93 | $363.08 |
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 $54.95 Median $54.95 Typical High $102.33 | Facility | 52 · Reduced service | $54.95 | $54.95 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $40.74 | Facility | 53 · Discontinued | $21.88 | $21.88 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $30.20 | Facility | 55 · Aftercare only | $16.60 | $16.60 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $20.42 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $54.95 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $21.88 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $16.60 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.96 | $20.42 | $22.91 |
Where North Dakota sits
The same service costs 3.8 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· 15th of 51
$251
AK $490DC $129
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.