How much rates vary
Facilitymedian $501 · 10th to 90th $398 to $2,570Professionalmedian $851 · 10th to 90th $490 to $1,175
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 $398.11 Median $478.63 Typical High $501.19 | Facility | None | $398.11 | $478.63 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $380.19 | Facility | 54 · Surgery only | $295.12 | $295.12 | $380.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $50.12 | Facility | 56 · Pre-op care only | $39.81 | $39.81 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $275.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $501.19 | Professional | None | $371.54 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $288.40 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $354.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,174.90 | Professional | None | $676.08 | $870.96 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $812.83 Median $1,047.13 Typical High $1,412.54 | Professional | 22 · Increased work | $812.83 | $1,047.13 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $616.60 Typical High $812.83 | Professional | 54 · Surgery only | $467.74 | $616.60 | $812.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $117.49 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $117.49 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $660.69 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $501.19 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Facility | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $870.96 Typical High $1,288.25 | Professional | None | $457.09 | $870.96 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $691.83 Typical High $2,511.89 | Facility | None | $398.11 | $691.83 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $3,090.30 | Professional | None | $512.86 | $1,000.00 | $3,090.30 |
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 $398.11 Median $758.58 Typical High $1,047.13 | Professional | None | $398.11 | $758.58 | $1,047.13 |
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 $194.98 Median $194.98 Typical High $251.19 | Facility | 52 · Reduced service | $194.98 | $194.98 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $100.00 | Facility | 53 · Discontinued | $79.43 | $79.43 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $75.86 | Facility | 55 · Aftercare only | $58.88 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $194.98 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $77.62 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $75.86 |
Where North Dakota sits
The same service costs 6.0 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
$813
AK $1,778TX $295
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.