How much rates vary
Facilitymedian $372 · 10th to 90th $145 to $1,698Professionalmedian $380 · 10th to 90th $195 to $891
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 $144.54 Median $363.08 Typical High $371.54 | Facility | None | $144.54 | $363.08 | $371.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $281.84 | Facility | 54 · Surgery only | $109.65 | $109.65 | $281.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $346.74 Typical High $467.74 | Professional | None | $138.04 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $281.84 | Professional | 54 · Surgery only | $109.65 | $134.90 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $125.89 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $102.33 | $125.89 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $891.25 | Professional | None | $281.84 | $416.87 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $331.13 Median $501.19 Typical High $1,071.52 | Professional | 22 · Increased work | $331.13 | $501.19 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $630.96 | Professional | 54 · Surgery only | $194.98 | $288.40 | $630.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $309.03 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $208.93 | $309.03 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Facility | None | $616.60 | $616.60 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $977.24 | Professional | None | $213.80 | $398.11 | $977.24 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $501.19 Typical High $1,698.24 | Facility | None | $144.54 | $501.19 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $1,348.96 | Professional | None | $380.19 | $724.44 | $1,348.96 |
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 $151.36 Median $363.08 Typical High $758.58 | Professional | None | $151.36 | $363.08 | $758.58 |
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 $72.44 Median $74.13 Typical High $186.21 | Facility | 52 · Reduced service | $72.44 | $74.13 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $74.13 | Facility | 53 · Discontinued | $28.84 | $29.51 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $56.23 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $37.15 | Facility | 56 · Pre-op care only | $14.45 | $14.79 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $91.20 Typical High $186.21 | Professional | 52 · Reduced service | $72.44 | $91.20 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $74.13 | Professional | 53 · Discontinued | $28.84 | $36.31 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $56.23 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $14.45 | $18.20 | $37.15 |
Where North Dakota sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 18th of 51
$380
AK $759KY $191
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.