How much rates vary
Facilitymedian $525 · 10th to 90th $324 to $1,549Professionalmedian $832 · 10th to 90th $501 to $1,318
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 $323.59 Median $524.81 Typical High $524.81 | Facility | None | $323.59 | $524.81 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $389.05 | Facility | 54 · Surgery only | $245.47 | $251.19 | $389.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $52.48 | Facility | 56 · Pre-op care only | $32.36 | $33.88 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $229.09 | $234.42 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $524.81 | Professional | None | $323.59 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $32.36 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $281.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $281.84 | $363.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,318.26 | Professional | None | $630.96 | $870.96 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $602.56 Typical High $933.25 | Professional | 54 · Surgery only | $436.52 | $602.56 | $933.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $87.10 Typical High $131.83 | Professional | 56 · Pre-op care only | $63.10 | $87.10 | $131.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $645.65 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $467.74 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Facility | None | $891.25 | $891.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $1,412.54 | Professional | None | $416.87 | $831.76 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $676.08 Typical High $1,548.82 | Facility | None | $323.59 | $676.08 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $2,454.71 | Professional | None | $537.03 | $954.99 | $2,454.71 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $1,000.00 | Professional | None | $338.84 | $602.56 | $1,000.00 |
8 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 $162.18 Median $169.82 Typical High $263.03 | Facility | 52 · Reduced service | $162.18 | $169.82 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $104.71 | Facility | 53 · Discontinued | $64.57 | $67.61 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $77.62 | Facility | 55 · Aftercare only | $48.98 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $162.18 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $64.57 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $77.62 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $758.58 Median $1,023.29 Typical High $1,584.89 | Professional | 22 · Increased work | $758.58 | $1,023.29 | $1,584.89 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,288.25 Typical High $1,995.26 | Professional | 50 · Both sides | $933.25 | $1,288.25 | $1,995.26 |
Where North Dakota sits
The same service costs 5.1 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
$776
AK $1,585TX $309
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.