How much rates vary
Facilitymedian $28 · 10th to 90th $27 to $263Professionalmedian $43 · 10th to 90th $27 to $95
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 $26.92 Median $26.92 Typical High $28.18 | Facility | None | $26.92 | $26.92 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $21.38 | Facility | 54 · Surgery only | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $28.18 Typical High $51.29 | Professional | None | $21.38 | $28.18 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $19.95 Typical High $21.38 | Professional | 54 · Surgery only | $15.85 | $19.95 | $21.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $47.86 | Professional | None | $33.11 | $39.81 | $47.86 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $28.18 Typical High $33.88 | Professional | 54 · Surgery only | $22.91 | $28.18 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $38.02 | Facility | None | $33.11 | $33.11 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $61.66 | Professional | None | $28.18 | $41.69 | $61.66 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $50.12 Typical High $263.03 | Facility | None | $26.92 | $50.12 | $263.03 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $81.28 Typical High $302.00 | Professional | None | $26.92 | $81.28 | $302.00 |
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 $26.92 Median $53.70 Typical High $107.15 | Professional | None | $26.92 | $53.70 | $107.15 |
11 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 $13.49 Median $13.49 Typical High $14.13 | Facility | 52 · Reduced service | $13.49 | $13.49 | $14.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.75 | Facility | 53 · Discontinued | $5.37 | $5.37 | $5.75 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | 55 · Aftercare only | $3.98 | $3.98 | $4.27 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.82 | Facility | 56 · Pre-op care only | $2.69 | $2.69 | $2.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $13.49 Typical High $14.13 | Professional | 52 · Reduced service | $10.72 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.37 Typical High $5.75 | Professional | 53 · Discontinued | $4.27 | $5.37 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.98 Typical High $4.27 | Professional | 55 · Aftercare only | $3.24 | $3.98 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.69 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.14 | $2.69 | $2.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $39.81 Median $47.86 Typical High $57.54 | Professional | 22 · Increased work | $39.81 | $47.86 | $57.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $60.26 Typical High $72.44 | Professional | 50 · Both sides | $48.98 | $60.26 | $72.44 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $24.55 Median $30.20 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $24.55 | $30.20 | $36.31 |
Where North Dakota sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 31st of 51
$41.69
WY $89.13NY $20.89
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.