How much rates vary
Facilitymedian $120 · 10th to 90th $98 to $275Professionalmedian $191 · 10th to 90th $102 to $275
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 $97.72 Median $102.33 Typical High $120.23 | Facility | None | $97.72 | $102.33 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $75.86 | Facility | 54 · Surgery only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $158.49 | Professional | None | $97.72 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $74.13 | $75.86 | $91.20 |
BCBS North Dakota Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $275.42 | Professional | None | $151.36 | $199.53 | $275.42 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $181.97 Median $239.88 Typical High $331.13 | Professional | 22 · Increased work | $181.97 | $239.88 | $331.13 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $302.00 Typical High $416.87 | Professional | 50 · Both sides | $223.87 | $302.00 | $416.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $141.25 | $194.98 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $151.36 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $112.20 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $223.87 | Facility | None | $194.98 | $194.98 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $309.03 | Professional | None | $97.72 | $199.53 | $309.03 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $295.12 | Facility | None | $97.72 | $134.90 | $295.12 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $288.40 | Professional | None | $102.33 | $204.17 | $288.40 |
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 $100.00 Median $181.97 Typical High $204.17 | Professional | None | $100.00 | $181.97 | $204.17 |
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 $48.98 Median $48.98 Typical High $50.12 | Facility | 52 · Reduced service | $48.98 | $48.98 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $20.42 | Facility | 53 · Discontinued | $19.95 | $19.95 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.00 | Facility | 56 · Pre-op care only | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $19.95 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $14.79 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $12.02 |
Where North Dakota sits
The same service costs 3.7 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· 9th of 51
$186
AK $363FL $97.72
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.