How much rates vary
Facilitymedian $398 · 10th to 90th $275 to $2,512Professionalmedian $631 · 10th to 90th $389 to $933
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 $275.42 Median $389.05 Typical High $398.11 | Facility | None | $275.42 | $389.05 | $398.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $39.81 | Facility | 56 · Pre-op care only | $27.54 | $27.54 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $398.11 | Professional | None | $269.15 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $33.88 | $39.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $933.25 | Professional | None | $489.78 | $676.08 | $933.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $588.84 Median $812.83 Typical High $1,122.02 | Professional | 22 · Increased work | $588.84 | $812.83 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $67.61 Typical High $93.33 | Professional | 56 · Pre-op care only | $48.98 | $67.61 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $630.96 Typical High $1,047.13 | Professional | None | $338.84 | $630.96 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $489.78 Typical High $2,454.71 | Facility | None | $275.42 | $489.78 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $1,949.84 | Professional | None | $398.11 | $758.58 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $812.83 | Professional | None | $281.84 | $537.03 | $812.83 |
10 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 $138.04 Median $138.04 Typical High $199.53 | Facility | 52 · Reduced service | $138.04 | $138.04 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $79.43 | Facility | 53 · Discontinued | $56.23 | $56.23 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $295.12 | Facility | 54 · Surgery only | $208.93 | $208.93 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $58.88 | Facility | 55 · Aftercare only | $41.69 | $41.69 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $194.98 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $190.55 | $234.42 | $275.42 |
Where North Dakota sits
The same service costs 5.2 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· 8th of 51
$589
AK $1,148TX $219
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.