How much rates vary
Facilitymedian $363 · 10th to 90th $257 to $759Professionalmedian $589 · 10th to 90th $309 to $955
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 $257.04 Median $363.08 Typical High $363.08 | Facility | None | $257.04 | $363.08 | $363.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $275.42 | Facility | 54 · Surgery only | $190.55 | $199.53 | $275.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $36.31 | Facility | 56 · Pre-op care only | $25.70 | $26.92 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $177.83 | $186.21 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $446.68 | Professional | None | $239.88 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $223.87 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $223.87 | $257.04 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS North Dakota Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $954.99 | Professional | None | $501.19 | $676.08 | $954.99 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $602.56 Median $812.83 Typical High $1,148.15 | Professional | 22 · Increased work | $602.56 | $812.83 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $478.63 Typical High $676.08 | Professional | 54 · Surgery only | $346.74 | $478.63 | $676.08 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $67.61 Typical High $95.50 | Professional | 56 · Pre-op care only | $50.12 | $67.61 | $95.50 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $512.86 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $371.54 | $512.86 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $758.58 | Facility | None | $645.65 | $645.65 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $1,023.29 | Professional | None | $331.13 | $630.96 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $446.68 Typical High $776.25 | Facility | None | $257.04 | $446.68 | $776.25 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $691.83 Typical High $1,949.84 | Professional | None | $371.54 | $691.83 | $1,949.84 |
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 $269.15 Median $489.78 Typical High $691.83 | Professional | None | $269.15 | $489.78 | $691.83 |
6 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 $128.82 Median $131.83 Typical High $181.97 | Facility | 52 · Reduced service | $128.82 | $131.83 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $72.44 | Facility | 53 · Discontinued | $51.29 | $53.70 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $54.95 | Facility | 55 · Aftercare only | $38.90 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $54.95 |
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
$589
AK $1,072TX $240
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.