How much rates vary
Facilitymedian $676 · 10th to 90th $380 to $4,266Professionalmedian $912 · 10th to 90th $589 to $1,622
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 $380.19 Median $645.65 Typical High $676.08 | Facility | None | $380.19 | $645.65 | $676.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $501.19 | Facility | 54 · Surgery only | $281.84 | $281.84 | $501.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $67.61 | Facility | 56 · Pre-op care only | $38.02 | $38.02 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $467.74 | Facility | 78 · Unplanned return to OR | $263.03 | $263.03 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $676.08 | Professional | None | $371.54 | $446.68 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $338.84 Typical High $501.19 | Professional | 54 · Surgery only | $275.42 | $338.84 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $44.67 Typical High $67.61 | Professional | 56 · Pre-op care only | $37.15 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $316.23 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $257.04 | $316.23 | $467.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,548.82 | Professional | None | $660.69 | $954.99 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $1,148.15 Typical High $1,862.09 | Professional | 22 · Increased work | $794.33 | $1,148.15 | $1,862.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $676.08 Typical High $1,071.52 | Professional | 54 · Surgery only | $467.74 | $676.08 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $95.50 Typical High $154.88 | Professional | 56 · Pre-op care only | $66.07 | $95.50 | $154.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $724.44 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $501.19 | $724.44 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,737.80 | Professional | None | $537.03 | $1,000.00 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $891.25 Typical High $4,265.80 | Facility | None | $380.19 | $891.25 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,513.56 Typical High $2,691.53 | Professional | None | $676.08 | $1,513.56 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $380.19 Median $776.25 Typical High $1,698.24 | Professional | None | $380.19 | $776.25 | $1,698.24 |
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 $186.21 Median $186.21 Typical High $338.84 | Facility | 52 · Reduced service | $186.21 | $186.21 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $134.90 | Facility | 53 · Discontinued | $75.86 | $75.86 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $102.33 | Facility | 55 · Aftercare only | $56.23 | $56.23 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $223.87 Typical High $338.84 | Professional | 52 · Reduced service | $186.21 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $134.90 | Professional | 53 · Discontinued | $74.13 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $67.61 Typical High $102.33 | Professional | 55 · Aftercare only | $54.95 | $67.61 | $102.33 |
Where North Dakota sits
The same service costs 4.9 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· 10th of 51
$891
AK $1,862TX $380
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.