How much rates vary
Facilitymedian $126 · 10th to 90th $49 to $575Professionalmedian $132 · 10th to 90th $78 to $288
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 $48.98 Median $107.15 Typical High $776.25 | Facility | None | $48.98 | $107.15 | $776.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $36.31 Median $36.31 Typical High $79.43 | Facility | 54 · Surgery only | $36.31 | $36.31 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $100.00 Typical High $147.91 | Professional | None | $48.98 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $48.98 Typical High $83.18 | Professional | 54 · Surgery only | $36.31 | $48.98 | $83.18 |
BCBS North Dakota Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $912.01 | Facility | None | $331.13 | $478.63 | $912.01 |
BCBS North Dakota Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $288.40 | Professional | None | $95.50 | $141.25 | $288.40 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $112.20 Median $169.82 Typical High $346.74 | Professional | 22 · Increased work | $112.20 | $169.82 | $346.74 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $213.80 Typical High $436.52 | Professional | 50 · Both sides | $141.25 | $213.80 | $436.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $204.17 | Professional | 54 · Surgery only | $66.07 | $97.72 | $204.17 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $104.71 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $70.79 | $104.71 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $223.87 | Facility | None | $190.55 | $190.55 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $302.00 | Professional | None | $75.86 | $151.36 | $302.00 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $125.89 Typical High $323.59 | Facility | None | $48.98 | $125.89 | $323.59 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $812.83 | Professional | None | $109.65 | $229.09 | $812.83 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $52.48 Median $125.89 Typical High $251.19 | Professional | None | $52.48 | $125.89 | $251.19 |
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 $24.55 Median $24.55 Typical High $53.70 | Facility | 52 · Reduced service | $24.55 | $24.55 | $53.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $21.38 | Facility | 53 · Discontinued | $9.77 | $9.77 | $21.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $7.41 Typical High $15.85 | Facility | 55 · Aftercare only | $7.24 | $7.41 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $10.72 | Facility | 56 · Pre-op care only | $4.90 | $4.90 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $33.11 Typical High $56.23 | Professional | 52 · Reduced service | $24.55 | $33.11 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $13.18 Typical High $22.39 | Professional | 53 · Discontinued | $9.77 | $13.18 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $16.60 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.61 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.90 | $6.61 | $11.22 |
Where North Dakota sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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
$132
AK $234KY $69.18
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.