How much rates vary
Facilitymedian $74 · 10th to 90th $44 to $759Professionalmedian $115 · 10th to 90th $71 to $200
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 $43.65 Median $74.13 Typical High $74.13 | Facility | None | $43.65 | $74.13 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $54.95 | Facility | 54 · Surgery only | $32.36 | $32.36 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $181.97 | Professional | None | $43.65 | $79.43 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $54.95 Typical High $58.88 | Professional | 54 · Surgery only | $32.36 | $54.95 | $58.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $181.97 | Professional | None | $77.62 | $114.82 | $181.97 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $93.33 Median $138.04 Typical High $218.78 | Professional | 22 · Increased work | $93.33 | $138.04 | $218.78 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $173.78 Typical High $275.42 | Professional | 50 · Both sides | $114.82 | $173.78 | $275.42 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $79.43 Typical High $128.82 | Professional | 54 · Surgery only | $53.70 | $79.43 | $128.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $85.11 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $57.54 | $85.11 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Facility | None | $138.04 | $138.04 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $213.80 | Professional | None | $69.18 | $123.03 | $213.80 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $112.20 Typical High $660.69 | Facility | None | $43.65 | $112.20 | $660.69 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $190.55 Typical High $269.15 | Professional | None | $75.86 | $190.55 | $269.15 |
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 $45.71 Median $134.90 Typical High $251.19 | Professional | None | $45.71 | $134.90 | $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 $21.88 Median $21.88 Typical High $36.31 | Facility | 52 · Reduced service | $21.88 | $21.88 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $14.79 | Facility | 53 · Discontinued | $8.71 | $8.71 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $10.96 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $7.41 | Facility | 56 · Pre-op care only | $4.37 | $4.37 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $21.88 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $14.79 Typical High $15.85 | Professional | 53 · Discontinued | $8.71 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.96 Typical High $12.02 | Professional | 55 · Aftercare only | $6.46 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.41 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.37 | $7.41 | $7.94 |
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· 14th of 51
$115
AK $191VA $60.26
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.