How much rates vary
Facilitymedian $63 · 10th to 90th $50 to $263Professionalmedian $100 · 10th to 90th $63 to $151
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 $50.12 Median $63.10 Typical High $63.10 | Facility | None | $50.12 | $63.10 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $37.15 Median $38.90 Typical High $47.86 | Facility | 54 · Surgery only | $37.15 | $38.90 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $67.61 | Professional | None | $50.12 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $38.90 Typical High $51.29 | Professional | 54 · Surgery only | $37.15 | $38.90 | $51.29 |
BCBS North Dakota Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $151.36 | Professional | None | $79.43 | $109.65 | $151.36 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $95.50 Median $128.82 Typical High $181.97 | Professional | 22 · Increased work | $95.50 | $128.82 | $181.97 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $162.18 Typical High $223.87 | Professional | 50 · Both sides | $120.23 | $162.18 | $223.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $54.95 | $75.86 | $104.71 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $81.28 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $58.88 | $81.28 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $125.89 | Facility | None | $109.65 | $109.65 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $173.78 | Professional | None | $54.95 | $112.20 | $173.78 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $263.03 | Facility | None | $50.12 | $107.15 | $263.03 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $436.52 | Professional | None | $64.57 | $117.49 | $436.52 |
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 $50.12 Median $95.50 Typical High $123.03 | Professional | None | $50.12 | $95.50 | $123.03 |
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 $24.55 Median $25.70 Typical High $31.62 | Facility | 52 · Reduced service | $24.55 | $25.70 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $12.59 | Facility | 53 · Discontinued | $10.00 | $10.23 | $12.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $9.55 | Facility | 55 · Aftercare only | $7.41 | $7.76 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $6.31 | Facility | 56 · Pre-op care only | $5.01 | $5.13 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $25.70 Typical High $33.88 | Professional | 52 · Reduced service | $24.55 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $13.49 | Professional | 53 · Discontinued | $10.00 | $10.23 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $10.23 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $6.76 |
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· 8th of 51
$100
AK $191FL $51.29
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.