How much rates vary
Facilitymedian $214 · 10th to 90th $148 to $759Professionalmedian $347 · 10th to 90th $182 to $550
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 $147.91 Median $213.80 Typical High $213.80 | Facility | None | $147.91 | $213.80 | $213.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $112.20 Typical High $158.49 | Facility | 54 · Surgery only | $109.65 | $112.20 | $158.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $104.71 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $102.33 | $104.71 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $269.15 | Professional | None | $131.83 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $102.33 | $128.82 | $147.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $562.34 | Professional | None | $281.84 | $380.19 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $338.84 Median $457.09 Typical High $676.08 | Professional | 22 · Increased work | $338.84 | $457.09 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $269.15 Typical High $389.05 | Professional | 54 · Surgery only | $199.53 | $269.15 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $288.40 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $213.80 | $288.40 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $602.56 | Professional | None | $199.53 | $371.54 | $602.56 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $660.69 | Facility | None | $147.91 | $257.04 | $660.69 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $1,096.48 | Professional | None | $218.78 | $407.38 | $1,096.48 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $407.38 | Professional | None | $151.36 | $281.84 | $407.38 |
8 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 $74.13 Median $74.13 Typical High $107.15 | Facility | 52 · Reduced service | $74.13 | $74.13 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $42.66 | Facility | 53 · Discontinued | $29.51 | $30.20 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $31.62 | Facility | 55 · Aftercare only | $21.88 | $22.39 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $21.38 | Facility | 56 · Pre-op care only | $14.79 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $74.13 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $21.88 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $18.62 | $21.38 |
Where North Dakota sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$331
AK $603FL $174
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.