How much rates vary
Facilitymedian $204 · 10th to 90th $79 to $1,202Professionalmedian $209 · 10th to 90th $107 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 $79.43 Median $204.17 Typical High $204.17 | Facility | None | $79.43 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $154.88 | Facility | 54 · Surgery only | $60.26 | $60.26 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $239.88 | Professional | None | $79.43 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $60.26 | $154.88 | $169.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $562.34 | Professional | None | $147.91 | $229.09 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $177.83 Median $275.42 Typical High $676.08 | Professional | 22 · Increased work | $177.83 | $275.42 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $398.11 | Professional | 54 · Surgery only | $104.71 | $162.18 | $398.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $173.78 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $112.20 | $173.78 | $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 $109.65 Median $234.42 Typical High $549.54 | Professional | None | $109.65 | $234.42 | $549.54 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $239.88 Typical High $1,202.26 | Facility | None | $79.43 | $239.88 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $1,659.59 | Professional | None | $177.83 | $323.59 | $1,659.59 |
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 $169.82 Typical High $354.81 | Professional | None | $81.28 | $169.82 | $354.81 |
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 $39.81 Median $39.81 Typical High $102.33 | Facility | 52 · Reduced service | $39.81 | $39.81 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $40.74 | Facility | 53 · Discontinued | $15.85 | $15.85 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $30.90 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $20.42 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $39.81 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $40.74 Typical High $44.67 | Professional | 53 · Discontinued | $15.85 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $12.02 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $7.94 | $20.42 | $22.39 |
Where North Dakota sits
The same service costs 4.1 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· 18th of 51
$209
AK $398DC $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.