How much rates vary
Facilitymedian $174 · 10th to 90th $129 to $759Professionalmedian $295 · 10th to 90th $174 to $457
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 $128.82 Median $173.78 Typical High $173.78 | Facility | None | $128.82 | $173.78 | $173.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $128.82 | Facility | 54 · Surgery only | $97.72 | $97.72 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $186.21 | Professional | None | $123.03 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $120.23 | $131.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $457.09 | Professional | None | $229.09 | $331.13 | $457.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $275.42 Median $398.11 Typical High $549.54 | Professional | 22 · Increased work | $275.42 | $398.11 | $549.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $229.09 Typical High $323.59 | Professional | 54 · Surgery only | $162.18 | $229.09 | $323.59 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $245.47 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $173.78 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $346.74 | Facility | None | $302.00 | $302.00 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $478.63 | Professional | None | $165.96 | $295.12 | $478.63 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $251.19 Typical High $758.58 | Facility | None | $128.82 | $251.19 | $758.58 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $954.99 | Professional | None | $181.97 | $338.84 | $954.99 |
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 $141.25 Median $251.19 Typical High $346.74 | Professional | None | $141.25 | $251.19 | $346.74 |
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 $64.57 Median $64.57 Typical High $87.10 | Facility | 52 · Reduced service | $64.57 | $64.57 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $34.67 | Facility | 53 · Discontinued | $25.70 | $25.70 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $25.70 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $17.38 | Facility | 56 · Pre-op care only | $12.88 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $81.28 Typical High $87.10 | Professional | 52 · Reduced service | $64.57 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.88 | $16.22 | $17.38 |
Where North Dakota sits
The same service costs 3.6 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· 9th of 51
$288
AK $537KY $148
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.