How much rates vary
Facilitymedian $708 · 10th to 90th $589 to $1,698Professionalmedian $1,318 · 10th to 90th $708 to $1,738
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 $588.84 Median $707.95 Typical High $707.95 | Facility | None | $588.84 | $707.95 | $707.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $69.18 | Facility | 56 · Pre-op care only | $58.88 | $60.26 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $407.38 | $426.58 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $724.44 | Professional | None | $588.84 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,380.38 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,348.96 Median $1,659.59 Typical High $2,089.30 | Professional | 22 · Increased work | $1,348.96 | $1,659.59 | $2,089.30 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $173.78 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $173.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,023.29 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,023.29 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,258.93 | $1,258.93 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,318.26 Typical High $1,995.26 | Professional | None | $645.65 | $1,318.26 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $1,737.80 | Facility | None | $588.84 | $831.76 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,412.54 Typical High $4,365.16 | Professional | None | $707.95 | $1,412.54 | $4,365.16 |
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 $588.84 Median $1,122.02 Typical High $1,513.56 | Professional | None | $588.84 | $1,122.02 | $1,513.56 |
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 $295.12 Median $302.00 Typical High $346.74 | Facility | 52 · Reduced service | $295.12 | $302.00 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $141.25 | Facility | 53 · Discontinued | $117.49 | $120.23 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $524.81 | Facility | 54 · Surgery only | $436.52 | $457.09 | $524.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $104.71 | Facility | 55 · Aftercare only | $87.10 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $109.65 |
Where North Dakota sits
The same service costs 5.6 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
$1,288
AK $2,399TX $427
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.