How much rates vary
Facilitymedian $85 · 10th to 90th $58 to $759Professionalmedian $138 · 10th to 90th $76 to $234
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 $57.54 Median $85.11 Typical High $501.19 | Facility | None | $57.54 | $85.11 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $64.57 | Facility | 54 · Surgery only | $42.66 | $42.66 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $147.91 | Professional | None | $57.54 | $85.11 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $56.23 Typical High $64.57 | Professional | 54 · Surgery only | $42.66 | $56.23 | $64.57 |
BCBS North Dakota Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $218.78 | Professional | None | $95.50 | $141.25 | $218.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $114.82 Median $169.82 Typical High $263.03 | Professional | 22 · Increased work | $114.82 | $169.82 | $263.03 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $208.93 Typical High $331.13 | Professional | 50 · Both sides | $144.54 | $208.93 | $331.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $97.72 Typical High $151.36 | Professional | 54 · Surgery only | $67.61 | $97.72 | $151.36 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $104.71 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $72.44 | $104.71 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Facility | None | $147.91 | $147.91 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $234.42 | Professional | None | $79.43 | $144.54 | $234.42 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $123.03 Typical High $758.58 | Facility | None | $57.54 | $123.03 | $758.58 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $218.78 Typical High $288.40 | Professional | None | $87.10 | $218.78 | $288.40 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $275.42 | Professional | None | $58.88 | $138.04 | $275.42 |
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 $28.18 Median $28.18 Typical High $42.66 | Facility | 52 · Reduced service | $28.18 | $28.18 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $16.98 | Facility | 53 · Discontinued | $11.48 | $11.48 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $12.88 | Facility | 55 · Aftercare only | $8.51 | $8.51 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $8.51 | Facility | 56 · Pre-op care only | $5.75 | $5.75 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $38.02 Typical High $42.66 | Professional | 52 · Reduced service | $28.18 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $15.14 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $8.51 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.75 | $7.59 | $8.51 |
Where North Dakota sits
The same service costs 3.2 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
$135
AK $224KY $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.