How much rates vary
Facilitymedian $148 · 10th to 90th $65 to $1,202Professionalmedian $166 · 10th to 90th $87 to $427
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 $64.57 Median $147.91 Typical High $147.91 | Facility | None | $64.57 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $112.20 | Facility | 54 · Surgery only | $47.86 | $47.86 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $147.91 Typical High $331.13 | Professional | None | $64.57 | $147.91 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $112.20 Typical High $128.82 | Professional | 54 · Surgery only | $47.86 | $112.20 | $128.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $426.58 | Professional | None | $123.03 | $186.21 | $426.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $223.87 Typical High $512.86 | Professional | 22 · Increased work | $147.91 | $223.87 | $512.86 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $302.00 | Professional | 54 · Surgery only | $85.11 | $128.82 | $302.00 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $138.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $91.20 | $138.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $331.13 | Facility | None | $288.40 | $288.40 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $416.87 | Professional | None | $93.33 | $177.83 | $416.87 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $190.55 Typical High $1,096.48 | Facility | None | $64.57 | $190.55 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $1,230.27 | Professional | None | $134.90 | $239.88 | $1,230.27 |
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 $66.07 Median $128.82 Typical High $263.03 | Professional | None | $66.07 | $128.82 | $263.03 |
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 $32.36 Median $32.36 Typical High $74.13 | Facility | 52 · Reduced service | $32.36 | $32.36 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $29.51 | Facility | 53 · Discontinued | $12.88 | $12.88 | $29.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $22.39 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $14.79 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $32.36 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $12.88 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $9.55 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $14.79 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.46 | $14.79 | $16.98 |
Where North Dakota sits
The same service costs 3.7 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
$162
AK $309DC $83.18
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.