How much rates vary
Facilitymedian $794 · 10th to 90th $661 to $1,698Professionalmedian $1,413 · 10th to 90th $794 to $1,950
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 $794.33 | Facility | None | $660.69 | $776.25 | $794.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $602.56 | Facility | 54 · Surgery only | $501.19 | $501.19 | $602.56 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $79.43 | Facility | 56 · Pre-op care only | $66.07 | $66.07 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $562.34 | Facility | 78 · Unplanned return to OR | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $812.83 | Professional | None | $602.56 | $676.08 | $812.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,445.44 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,348.96 Median $1,737.80 Typical High $2,344.23 | Professional | 22 · Increased work | $1,348.96 | $1,737.80 | $2,344.23 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,023.29 Typical High $1,348.96 | Professional | 54 · Surgery only | $794.33 | $1,023.29 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $144.54 Typical High $194.98 | Professional | 56 · Pre-op care only | $112.20 | $144.54 | $194.98 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,096.48 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $851.14 | $1,096.48 | $1,445.44 |
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 $1,148.15 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,548.82 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $891.25 Typical High $1,778.28 | Facility | None | $660.69 | $891.25 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $4,786.30 | Professional | None | $812.83 | $1,513.56 | $4,786.30 |
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 $676.08 Median $1,258.93 Typical High $1,621.81 | Professional | None | $676.08 | $1,258.93 | $1,621.81 |
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 $398.11 | Facility | 52 · Reduced service | $331.13 | $331.13 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | 53 · Discontinued | $131.83 | $131.83 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $120.23 | Facility | 55 · Aftercare only | $100.00 | $100.00 | $120.23 |
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· 7th of 51
$1,349
AK $2,630TX $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.