How much rates vary
Facilitymedian $31 · 10th to 90th $28 to $263Professionalmedian $54 · 10th to 90th $30 to $71
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 $28.18 Median $29.51 Typical High $29.51 | Facility | None | $28.18 | $29.51 | $29.51 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $22.39 | Facility | 54 · Surgery only | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $30.90 | Professional | None | $28.18 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $22.39 Typical High $22.91 | Professional | 54 · Surgery only | $21.38 | $22.39 | $22.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $70.79 | Professional | None | $43.65 | $56.23 | $70.79 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $52.48 Median $67.61 Typical High $85.11 | Professional | 22 · Increased work | $52.48 | $67.61 | $85.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $39.81 Typical High $48.98 | Professional | 54 · Surgery only | $30.90 | $39.81 | $48.98 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $42.66 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $33.11 | $42.66 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $57.54 | Facility | None | $50.12 | $50.12 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $58.88 Typical High $79.43 | Professional | None | $25.70 | $58.88 | $79.43 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $48.98 Typical High $263.03 | Facility | None | $28.18 | $48.98 | $263.03 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $56.23 Typical High $512.86 | Professional | None | $30.90 | $56.23 | $512.86 |
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 $28.84 Median $51.29 Typical High $58.88 | Professional | None | $28.84 | $51.29 | $58.88 |
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 $14.13 Median $14.45 Typical High $14.79 | Facility | 52 · Reduced service | $14.13 | $14.45 | $14.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.62 Median $5.75 Typical High $5.89 | Facility | 53 · Discontinued | $5.62 | $5.75 | $5.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.47 | Facility | 55 · Aftercare only | $4.27 | $4.27 | $4.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $2.95 | Facility | 56 · Pre-op care only | $2.82 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.79 Typical High $15.49 | Professional | 52 · Reduced service | $14.13 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.89 Typical High $6.17 | Professional | 53 · Discontinued | $5.62 | $5.89 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $4.57 | Professional | 55 · Aftercare only | $4.27 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.95 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.82 | $2.95 | $3.09 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 8th of 51
$52.48
AK $110NJ $26.92
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.