How much rates vary
Facilitymedian $257 · 10th to 90th $120 to $363Professionalmedian $295 · 10th to 90th $155 to $676
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 $120.23 Median $251.19 Typical High $257.04 | Facility | None | $120.23 | $251.19 | $257.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $194.98 | Facility | 54 · Surgery only | $91.20 | $91.20 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $288.40 | Professional | None | $109.65 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $194.98 | Professional | 54 · Surgery only | $83.18 | $120.23 | $194.98 |
BCBS North Dakota Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $588.84 | Professional | None | $199.53 | $323.59 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $239.88 Median $389.05 Typical High $707.95 | Professional | 22 · Increased work | $239.88 | $389.05 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $229.09 Typical High $416.87 | Professional | 54 · Surgery only | $141.25 | $229.09 | $416.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $245.47 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $151.36 | $245.47 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $281.84 Typical High $616.60 | Professional | None | $134.90 | $281.84 | $616.60 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $257.04 Typical High $436.52 | Facility | None | $120.23 | $257.04 | $436.52 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $724.44 Typical High $1,862.09 | Professional | None | $275.42 | $724.44 | $1,862.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $263.03 Typical High $489.78 | Professional | None | $128.82 | $263.03 | $489.78 |
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 $60.26 Median $60.26 Typical High $128.82 | Facility | 52 · Reduced service | $60.26 | $60.26 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $51.29 | Facility | 53 · Discontinued | $23.99 | $23.99 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $38.90 | Facility | 55 · Aftercare only | $18.20 | $18.20 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $25.70 | Facility | 56 · Pre-op care only | $12.02 | $12.02 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $79.43 Typical High $128.82 | Professional | 52 · Reduced service | $54.95 | $79.43 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $31.62 Typical High $51.29 | Professional | 53 · Discontinued | $21.88 | $31.62 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.99 Typical High $38.90 | Professional | 55 · Aftercare only | $16.60 | $23.99 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $25.70 |
Where North Dakota sits
The same service costs 3.4 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
$288
AK $513VA $151
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.