How much rates vary
Facilitymedian $112 · 10th to 90th $56 to $759Professionalmedian $138 · 10th to 90th $87 to $282
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 $56.23 Median $109.65 Typical High $112.20 | Facility | None | $56.23 | $109.65 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $85.11 | Facility | 54 · Surgery only | $41.69 | $41.69 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $165.96 | Professional | None | $56.23 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $69.18 Typical High $85.11 | Professional | 54 · Surgery only | $41.69 | $69.18 | $85.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $288.40 | Professional | None | $100.00 | $147.91 | $288.40 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $120.23 Median $177.83 Typical High $338.84 | Professional | 22 · Increased work | $120.23 | $177.83 | $338.84 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $223.87 Typical High $426.58 | Professional | 50 · Both sides | $147.91 | $223.87 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $104.71 Typical High $199.53 | Professional | 54 · Surgery only | $69.18 | $104.71 | $199.53 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $112.20 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $74.13 | $112.20 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Facility | None | $190.55 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $302.00 | Professional | None | $89.13 | $144.54 | $302.00 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $131.83 Typical High $660.69 | Facility | None | $56.23 | $131.83 | $660.69 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $295.12 | Professional | None | $114.82 | $234.42 | $295.12 |
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 $57.54 Median $151.36 Typical High $263.03 | Professional | None | $57.54 | $151.36 | $263.03 |
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 $27.54 Median $27.54 Typical High $56.23 | Facility | 52 · Reduced service | $27.54 | $27.54 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $22.39 | Facility | 53 · Discontinued | $11.22 | $11.22 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $16.98 | Facility | 55 · Aftercare only | $8.32 | $8.32 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $11.22 | Facility | 56 · Pre-op care only | $5.62 | $5.62 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $27.54 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $18.62 Typical High $22.39 | Professional | 53 · Discontinued | $11.22 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.80 Typical High $16.98 | Professional | 55 · Aftercare only | $8.32 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $9.33 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.62 | $9.33 | $11.22 |
Where North Dakota sits
The same service costs 3.2 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· 18th of 51
$138
AK $263VA $81.28
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.