How much rates vary
Facilitymedian $776 · 10th to 90th $617 to $1,698Professionalmedian $1,318 · 10th to 90th $776 to $1,905
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 $616.60 Median $758.58 Typical High $776.25 | Facility | None | $616.60 | $758.58 | $776.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $575.44 | Facility | 54 · Surgery only | $457.09 | $457.09 | $575.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $77.62 | Facility | 56 · Pre-op care only | $61.66 | $61.66 | $77.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $537.03 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $776.25 | Professional | None | $562.34 | $630.96 | $776.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,380.38 | $1,905.46 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,288.25 Median $1,659.59 Typical High $2,290.87 | Professional | 22 · Increased work | $1,288.25 | $1,659.59 | $2,290.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $977.24 Typical High $1,318.26 | Professional | 54 · Surgery only | $758.58 | $977.24 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $190.55 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $190.55 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $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 $1,023.29 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,479.11 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,778.28 | Facility | None | $616.60 | $831.76 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $4,570.88 | Professional | None | $794.33 | $1,445.44 | $4,570.88 |
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 $630.96 Median $1,148.15 Typical High $1,548.82 | Professional | None | $630.96 | $1,148.15 | $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 $302.00 Median $302.00 Typical High $389.05 | Facility | 52 · Reduced service | $302.00 | $302.00 | $389.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $154.88 | Facility | 53 · Discontinued | $123.03 | $123.03 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $114.82 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $114.82 |
Where North Dakota sits
The same service costs 4.2 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
$1,259
AK $2,455TX $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.