How much rates vary
Facilitymedian $89 · 10th to 90th $52 to $398Professionalmedian $120 · 10th to 90th $71 to $191
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 $52.48 Median $70.79 Typical High $416.87 | Facility | None | $52.48 | $70.79 | $416.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $53.70 | Facility | 54 · Surgery only | $38.90 | $38.90 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $138.04 | Professional | None | $52.48 | $79.43 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $53.70 Typical High $57.54 | Professional | 54 · Surgery only | $38.90 | $53.70 | $57.54 |
BCBS North Dakota Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $190.55 | Professional | None | $91.20 | $131.83 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $109.65 Median $158.49 Typical High $229.09 | Professional | 22 · Increased work | $109.65 | $158.49 | $229.09 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $194.98 Typical High $288.40 | Professional | 50 · Both sides | $138.04 | $194.98 | $288.40 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $91.20 Typical High $134.90 | Professional | 54 · Surgery only | $64.57 | $91.20 | $134.90 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $97.72 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $69.18 | $97.72 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Facility | None | $125.89 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $199.53 | Professional | None | $72.44 | $128.82 | $199.53 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $120.23 Typical High $269.15 | Facility | None | $52.48 | $120.23 | $269.15 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $199.53 | Professional | None | $74.13 | $165.96 | $199.53 |
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 $56.23 Median $112.20 Typical High $190.55 | Professional | None | $56.23 | $112.20 | $190.55 |
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 $26.30 Median $26.30 Typical High $35.48 | Facility | 52 · Reduced service | $26.30 | $26.30 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $14.13 | Facility | 53 · Discontinued | $10.47 | $10.47 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $10.72 | Facility | 55 · Aftercare only | $7.76 | $7.76 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.08 | Facility | 56 · Pre-op care only | $5.25 | $5.25 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $35.48 Typical High $38.02 | Professional | 52 · Reduced service | $26.30 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.13 Typical High $15.14 | Professional | 53 · Discontinued | $10.47 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $7.76 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.08 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.25 | $7.08 | $7.59 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 9th of 51
$117
AK $214TX $67.61
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.