How much rates vary
Facilitymedian $1,000 · 10th to 90th $832 to $1,778Professionalmedian $1,778 · 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 $851.14 Median $1,000.00 Typical High $1,000.00 | Facility | None | $851.14 | $1,000.00 | $1,000.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $758.58 | Facility | 54 · Surgery only | $630.96 | $630.96 | $758.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $100.00 | Facility | 56 · Pre-op care only | $85.11 | $85.11 | $100.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | 78 · Unplanned return to OR | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,023.29 | Professional | None | $776.25 | $870.96 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,862.09 | $2,454.71 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,737.80 Median $2,238.72 Typical High $2,951.21 | Professional | 22 · Increased work | $1,737.80 | $2,238.72 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,023.29 | $1,318.26 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $186.21 Typical High $245.47 | Professional | 56 · Pre-op care only | $144.54 | $186.21 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,412.54 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,412.54 | $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 $1,412.54 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,412.54 | $2,041.74 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,778.28 | Facility | None | $831.76 | $1,000.00 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $6,309.57 | Professional | None | $1,023.29 | $1,905.46 | $6,309.57 |
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 $870.96 Median $1,621.81 Typical High $1,995.26 | Professional | None | $870.96 | $1,621.81 | $1,995.26 |
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 $426.58 Median $426.58 Typical High $501.19 | Facility | 52 · Reduced service | $426.58 | $426.58 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $199.53 | Facility | 53 · Discontinued | $169.82 | $169.82 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $151.36 | Facility | 55 · Aftercare only | $128.82 | $128.82 | $151.36 |
Where North Dakota sits
The same service costs 4.4 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· 7th of 51
$1,698
AK $3,311TX $759
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.