How much rates vary
Facilitymedian $776 · 10th to 90th $661 to $1,778Professionalmedian $1,349 · 10th to 90th $776 to $1,862
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 $660.69 Median $776.25 Typical High $5,011.87 | Facility | None | $660.69 | $776.25 | $5,011.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $575.44 | Facility | 54 · Surgery only | $501.19 | $501.19 | $575.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $77.62 | Facility | 56 · Pre-op care only | $66.07 | $66.07 | $77.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $537.03 | Facility | 78 · Unplanned return to OR | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $851.14 | Professional | None | $616.60 | $691.83 | $851.14 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,479.11 | $1,862.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,380.38 Median $1,778.28 Typical High $2,238.72 | Professional | 22 · Increased work | $1,380.38 | $1,778.28 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,023.29 Typical High $1,318.26 | Professional | 54 · Surgery only | $794.33 | $1,023.29 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $147.91 Typical High $186.21 | Professional | 56 · Pre-op care only | $114.82 | $147.91 | $186.21 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $851.14 | $1,096.48 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Facility | None | $1,348.96 | $1,348.96 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,584.89 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $912.01 Typical High $1,995.26 | Facility | None | $660.69 | $912.01 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $1,995.26 | Professional | None | $794.33 | $1,380.38 | $1,995.26 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,548.82 | Professional | None | $691.83 | $1,258.93 | $1,548.82 |
3 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 $331.13 Median $331.13 Typical High $389.05 | Facility | 52 · Reduced service | $331.13 | $331.13 | $389.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $154.88 | Facility | 53 · Discontinued | $131.83 | $131.83 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $114.82 | Facility | 55 · Aftercare only | $100.00 | $100.00 | $114.82 |
Where North Dakota sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 6th of 51
$1,349
AK $2,692TX $589
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.