How much rates vary
Facilitymedian $115 · 10th to 90th $79 to $269Professionalmedian $178 · 10th to 90th $105 to $309
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 $79.43 Median $114.82 Typical High $114.82 | Facility | None | $79.43 | $114.82 | $114.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $87.10 | Facility | 54 · Surgery only | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $123.03 | Professional | None | $74.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $77.62 Typical High $87.10 | Professional | 54 · Surgery only | $60.26 | $77.62 | $87.10 |
BCBS North Dakota Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $316.23 | Professional | None | $141.25 | $204.17 | $316.23 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $169.82 Median $245.47 Typical High $371.54 | Professional | 22 · Increased work | $169.82 | $245.47 | $371.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $218.78 | Professional | 54 · Surgery only | $97.72 | $144.54 | $218.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $154.88 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $104.71 | $154.88 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Facility | None | $204.17 | $204.17 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $316.23 | Professional | None | $107.15 | $194.98 | $316.23 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $269.15 | Facility | None | $79.43 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $588.84 | Professional | None | $120.23 | $223.87 | $588.84 |
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 $85.11 Median $151.36 Typical High $223.87 | Professional | None | $85.11 | $151.36 | $223.87 |
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 $39.81 Median $39.81 Typical High $57.54 | Facility | 52 · Reduced service | $39.81 | $39.81 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $22.91 | Facility | 53 · Discontinued | $16.22 | $16.22 | $22.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $17.38 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $11.48 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $52.48 Typical High $58.88 | Professional | 52 · Reduced service | $39.81 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.89 Typical High $23.44 | Professional | 53 · Discontinued | $16.22 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $11.75 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 10th of 51
$170
AK $331FL $93.33
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.