How much rates vary
Facilitymedian $871 · 10th to 90th $214 to $1,479Professionalmedian $871 · 10th to 90th $275 to $2,344
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 $213.80 Median $870.96 Typical High $870.96 | Facility | None | $213.80 | $870.96 | $870.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $645.65 | Facility | 54 · Surgery only | $162.18 | $162.18 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $724.44 Typical High $912.01 | Professional | None | $194.98 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $229.09 Typical High $660.69 | Professional | 54 · Surgery only | $144.54 | $229.09 | $660.69 |
BCBS North Dakota Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $1,949.84 | Professional | None | $363.08 | $575.44 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $436.52 Median $691.83 Typical High $2,344.23 | Professional | 22 · Increased work | $436.52 | $691.83 | $2,344.23 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $257.04 | $407.38 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $691.83 Typical High $2,041.74 | Professional | None | $239.88 | $691.83 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $645.65 Typical High $1,479.11 | Facility | None | $213.80 | $645.65 | $1,479.11 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $2,398.83 Typical High $6,165.95 | Professional | None | $933.25 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $229.09 Median $794.33 Typical High $1,659.59 | Professional | None | $229.09 | $794.33 | $1,659.59 |
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 $107.15 Median $107.15 Typical High $436.52 | Facility | 52 · Reduced service | $107.15 | $107.15 | $436.52 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $173.78 | Facility | 53 · Discontinued | $42.66 | $42.66 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $128.82 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $87.10 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $151.36 Typical High $446.68 | Professional | 52 · Reduced service | $97.72 | $151.36 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $61.66 Typical High $177.83 | Professional | 53 · Discontinued | $38.90 | $61.66 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $45.71 Typical High $131.83 | Professional | 55 · Aftercare only | $29.51 | $45.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $30.20 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.50 | $30.20 | $89.13 |
Where North Dakota sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 17th of 51
$871
WI $1,514MD $282
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.