How much rates vary
Facilitymedian $110 · 10th to 90th $71 to $186Professionalmedian $166 · 10th to 90th $93 to $324
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 $70.79 Median $109.65 Typical High $109.65 | Facility | None | $70.79 | $109.65 | $109.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $81.28 | Facility | 54 · Surgery only | $53.70 | $53.70 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $223.87 | Professional | None | $69.18 | $109.65 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $72.44 Typical High $91.20 | Professional | 54 · Surgery only | $52.48 | $72.44 | $91.20 |
BCBS North Dakota Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $281.84 | Professional | None | $123.03 | $181.97 | $281.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $218.78 Typical High $338.84 | Professional | 22 · Increased work | $147.91 | $218.78 | $338.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $128.82 | $199.53 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $138.04 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $93.33 | $138.04 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $316.23 | Professional | None | $74.13 | $147.91 | $316.23 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $109.65 Typical High $213.80 | Facility | None | $70.79 | $109.65 | $213.80 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $1,071.52 Typical High $3,548.13 | Professional | None | $112.20 | $1,071.52 | $3,548.13 |
United Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $218.78 | Professional | None | $72.44 | $134.90 | $218.78 |
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 $35.48 Median $35.48 Typical High $54.95 | Facility | 52 · Reduced service | $35.48 | $35.48 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $21.88 | Facility | 53 · Discontinued | $14.13 | $14.13 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $16.60 | Facility | 55 · Aftercare only | $10.72 | $10.72 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.96 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $47.86 Typical High $61.66 | Professional | 52 · Reduced service | $34.67 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.05 Typical High $24.55 | Professional | 53 · Discontinued | $13.80 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.45 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.55 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.92 | $9.55 | $12.30 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 12th of 51
$155
AK $282FL $87.10
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.