How much rates vary
Facilitymedian $117 · 10th to 90th $102 to $269Professionalmedian $204 · 10th to 90th $110 to $282
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 $102.33 Median $117.49 Typical High $117.49 | Facility | None | $102.33 | $117.49 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $81.28 Typical High $87.10 | Facility | 54 · Surgery only | $77.62 | $81.28 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $123.03 | Professional | None | $91.20 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $77.62 | $83.18 | $93.33 |
BCBS North Dakota Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $281.84 | Professional | None | $169.82 | $218.78 | $281.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $204.17 Median $263.03 Typical High $338.84 | Professional | 22 · Increased work | $204.17 | $263.03 | $338.84 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $323.59 Typical High $416.87 | Professional | 50 · Both sides | $257.04 | $323.59 | $416.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $151.36 Typical High $194.98 | Professional | 54 · Surgery only | $120.23 | $151.36 | $194.98 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $162.18 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $128.82 | $162.18 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $229.09 | Facility | None | $199.53 | $199.53 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $316.23 | Professional | None | $100.00 | $218.78 | $316.23 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $269.15 | Facility | None | $102.33 | $144.54 | $269.15 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $812.83 | Professional | None | $117.49 | $213.80 | $812.83 |
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 $104.71 Median $186.21 Typical High $229.09 | Professional | None | $104.71 | $186.21 | $229.09 |
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 $51.29 Median $53.70 Typical High $57.54 | Facility | 52 · Reduced service | $51.29 | $53.70 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $23.44 | Facility | 53 · Discontinued | $20.42 | $21.38 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $17.38 | Facility | 55 · Aftercare only | $15.49 | $16.22 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $11.75 | Facility | 56 · Pre-op care only | $10.23 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $15.49 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $12.30 |
Where North Dakota sits
The same service costs 4.5 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· 7th of 51
$200
AK $407FL $91.20
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.