How much rates vary
Facilitymedian $1,000 · 10th to 90th $813 to $1,738Professionalmedian $1,698 · 10th to 90th $1,000 to $2,455
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 $812.83 Median $1,000.00 Typical High $1,737.80 | Facility | None | $812.83 | $1,000.00 | $1,737.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $758.58 | Facility | 54 · Surgery only | $616.60 | $616.60 | $758.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $100.00 | Facility | 56 · Pre-op care only | $81.28 | $81.28 | $100.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $707.95 | Facility | 78 · Unplanned return to OR | $575.44 | $575.44 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,096.48 | Professional | None | $776.25 | $891.25 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,819.70 | $2,454.71 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,659.59 Median $2,187.76 Typical High $2,884.03 | Professional | 22 · Increased work | $1,659.59 | $2,187.76 | $2,884.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,258.93 Typical High $1,698.24 | Professional | 54 · Surgery only | $977.24 | $1,258.93 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $181.97 Typical High $245.47 | Professional | 56 · Pre-op care only | $138.04 | $181.97 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,348.96 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,348.96 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,737.80 | $1,737.80 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,949.84 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Facility | None | $812.83 | $1,023.29 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $6,025.60 | Professional | None | $1,023.29 | $1,905.46 | $6,025.60 |
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 $851.14 Median $1,548.82 Typical High $2,041.74 | Professional | None | $851.14 | $1,548.82 | $2,041.74 |
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 $407.38 Median $407.38 Typical High $501.19 | Facility | 52 · Reduced service | $407.38 | $407.38 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Facility | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $151.36 | Facility | 55 · Aftercare only | $123.03 | $123.03 | $151.36 |
Where North Dakota sits
The same service costs 4.5 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· 8th of 51
$1,660
AK $3,311TX $741
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.