How much rates vary
Facilitymedian $69 · 10th to 90th $51 to $263Professionalmedian $105 · 10th to 90th $63 to $162
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 $51.29 Median $69.18 Typical High $69.18 | Facility | None | $51.29 | $69.18 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.90 Median $39.81 Typical High $51.29 | Facility | 54 · Surgery only | $38.90 | $39.81 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $74.13 | Professional | None | $51.29 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $40.74 Typical High $54.95 | Professional | 54 · Surgery only | $38.90 | $40.74 | $54.95 |
BCBS North Dakota Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
BCBS North Dakota Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $162.18 | Professional | None | $83.18 | $112.20 | $162.18 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $114.82 Median $158.49 Typical High $194.98 | Professional | 22 · Increased work | $114.82 | $158.49 | $194.98 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $169.82 Typical High $245.47 | Professional | 50 · Both sides | $125.89 | $169.82 | $245.47 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $79.43 Typical High $114.82 | Professional | 54 · Surgery only | $58.88 | $79.43 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $79.43 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $61.66 | $79.43 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Facility | None | $117.49 | $117.49 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $186.21 | Professional | None | $58.88 | $120.23 | $186.21 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $97.72 Typical High $263.03 | Facility | None | $51.29 | $97.72 | $263.03 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $380.19 | Professional | None | $69.18 | $125.89 | $380.19 |
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 $52.48 Median $97.72 Typical High $134.90 | Professional | None | $52.48 | $97.72 | $134.90 |
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 $25.70 Median $26.30 Typical High $34.67 | Facility | 52 · Reduced service | $25.70 | $26.30 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $13.80 | Facility | 53 · Discontinued | $10.23 | $10.72 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.94 Typical High $10.23 | Facility | 55 · Aftercare only | $7.76 | $7.94 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $6.92 | Facility | 56 · Pre-op care only | $5.13 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $27.54 Typical High $36.31 | Professional | 52 · Reduced service | $25.70 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.96 Typical High $14.79 | Professional | 53 · Discontinued | $10.23 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $10.96 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.50 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.13 | $5.50 | $7.24 |
Where North Dakota sits
The same service costs 3.6 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
$105
AK $200FL $54.95
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.