How much rates vary
Facilitymedian $692 · 10th to 90th $575 to $2,570Professionalmedian $1,175 · 10th to 90th $692 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 $575.44 Median $645.65 Typical High $691.83 | Facility | None | $575.44 | $645.65 | $691.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $512.86 | Facility | 54 · Surgery only | $436.52 | $436.52 | $512.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $69.18 | Facility | 56 · Pre-op care only | $57.54 | $57.54 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $691.83 | Professional | None | $575.44 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $478.63 |
BCBS North Dakota Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,584.89 | Professional | None | $977.24 | $1,230.27 | $1,584.89 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,174.90 Median $1,479.11 Typical High $1,905.46 | Professional | 22 · Increased work | $1,174.90 | $1,479.11 | $1,905.46 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $1,096.48 | Professional | 54 · Surgery only | $676.08 | $870.96 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $158.49 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $158.49 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Facility | None | $1,122.02 | $1,122.02 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,737.80 | Professional | None | $676.08 | $1,174.90 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $2,511.89 | Facility | None | $575.44 | $1,023.29 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,479.11 Typical High $5,754.40 | Professional | None | $707.95 | $1,479.11 | $5,754.40 |
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 $588.84 Median $1,202.26 Typical High $1,621.81 | Professional | None | $588.84 | $1,202.26 | $1,621.81 |
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 $288.40 Median $288.40 Typical High $346.74 | Facility | 52 · Reduced service | $288.40 | $288.40 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $138.04 | Facility | 53 · Discontinued | $114.82 | $114.82 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $102.33 | Facility | 55 · Aftercare only | $87.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $102.33 |
Where North Dakota sits
The same service costs 6.2 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· 7th of 51
$1,175
AK $2,570TX $417
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.