How much rates vary
Facilitymedian $129 · 10th to 90th $43 to $1,047Professionalmedian $102 · 10th to 90th $66 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 $42.66 Median $77.62 Typical High $588.84 | Facility | None | $42.66 | $77.62 | $588.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $57.54 | Facility | 54 · Surgery only | $32.36 | $32.36 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $138.04 | Professional | None | $42.66 | $77.62 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $51.29 Typical High $57.54 | Professional | 54 · Surgery only | $32.36 | $51.29 | $57.54 |
BCBS North Dakota Setting Facility Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,288.25 | Facility | None | $812.83 | $1,000.00 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $190.55 | Professional | None | $75.86 | $114.82 | $190.55 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $91.20 Median $138.04 Typical High $229.09 | Professional | 22 · Increased work | $91.20 | $138.04 | $229.09 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $169.82 Typical High $288.40 | Professional | 50 · Both sides | $114.82 | $169.82 | $288.40 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $79.43 Typical High $134.90 | Professional | 54 · Surgery only | $53.70 | $79.43 | $134.90 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $85.11 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $57.54 | $85.11 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Facility | None | $128.82 | $128.82 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $204.17 | Professional | None | $60.26 | $112.20 | $204.17 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $131.83 Typical High $776.25 | Facility | None | $42.66 | $131.83 | $776.25 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $724.44 | Professional | None | $79.43 | $151.36 | $724.44 |
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 $44.67 Median $89.13 Typical High $162.18 | Professional | None | $44.67 | $89.13 | $162.18 |
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 $21.38 Median $21.38 Typical High $38.90 | Facility | 52 · Reduced service | $21.38 | $21.38 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $15.49 | Facility | 53 · Discontinued | $8.51 | $8.51 | $15.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $11.48 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $7.76 | Facility | 56 · Pre-op care only | $4.27 | $4.27 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $33.88 Typical High $38.90 | Professional | 52 · Reduced service | $21.38 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.80 Typical High $15.49 | Professional | 53 · Discontinued | $8.51 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.23 Typical High $11.48 | Professional | 55 · Aftercare only | $6.46 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.27 | $6.92 | $7.76 |
Where North Dakota sits
The same service costs 3.5 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
$102
AK $204VA $58.88
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.