How much rates vary
Facilitymedian $339 · 10th to 90th $158 to $479Professionalmedian $389 · 10th to 90th $204 to $912
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 $158.49 Median $309.03 Typical High $338.84 | Facility | None | $158.49 | $309.03 | $338.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $257.04 | Facility | 54 · Surgery only | $120.23 | $120.23 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $338.84 | Professional | None | $138.04 | $208.93 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $154.88 Typical High $257.04 | Professional | 54 · Surgery only | $102.33 | $154.88 | $257.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $794.33 | Professional | None | $269.15 | $398.11 | $794.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $316.23 Median $478.63 Typical High $954.99 | Professional | 22 · Increased work | $316.23 | $478.63 | $954.99 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $562.34 | Professional | 54 · Surgery only | $186.21 | $275.42 | $562.34 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $295.12 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $199.53 | $295.12 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $758.58 | Professional | None | $173.78 | $380.19 | $758.58 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $338.84 Typical High $575.44 | Facility | None | $158.49 | $338.84 | $575.44 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,174.90 Typical High $2,344.23 | Professional | None | $371.54 | $1,174.90 | $2,344.23 |
United Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $660.69 | Professional | None | $165.96 | $346.74 | $660.69 |
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 $79.43 Median $79.43 Typical High $169.82 | Facility | 52 · Reduced service | $79.43 | $79.43 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $67.61 | Facility | 53 · Discontinued | $31.62 | $31.62 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $51.29 | Facility | 55 · Aftercare only | $23.99 | $23.99 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $33.88 | Facility | 56 · Pre-op care only | $15.85 | $15.85 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $104.71 Typical High $169.82 | Professional | 52 · Reduced service | $67.61 | $104.71 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $41.69 Typical High $67.61 | Professional | 53 · Discontinued | $27.54 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.90 Typical High $51.29 | Professional | 55 · Aftercare only | $20.42 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.89 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.80 | $20.89 | $33.88 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 14th of 51
$363
AK $661VA $186
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.