How much rates vary
Facilitymedian $234 · 10th to 90th $234 to $1,202Professionalmedian $513 · 10th to 90th $245 to $661
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 $234.42 Median $234.42 Typical High $251.19 | Facility | None | $234.42 | $234.42 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | 54 · Surgery only | $177.83 | $177.83 | $177.83 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | None | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | 54 · Surgery only | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $177.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $660.69 | Professional | None | $446.68 | $562.34 | $660.69 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $389.05 | $457.09 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $44.67 | $56.23 | $66.07 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $416.87 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $501.19 | Facility | None | $436.52 | $436.52 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $524.81 Typical High $794.33 | Professional | None | $239.88 | $524.81 | $794.33 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $1,202.26 | Facility | None | $234.42 | $398.11 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $1,819.70 | Professional | None | $245.47 | $457.09 | $1,819.70 |
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 $245.47 Median $436.52 Typical High $524.81 | Professional | None | $245.47 | $436.52 | $524.81 |
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 $117.49 Median $117.49 Typical High $117.49 | Facility | 52 · Reduced service | $117.49 | $117.49 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $47.86 | Facility | 53 · Discontinued | $46.77 | $47.86 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | 55 · Aftercare only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $46.77 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $38.02 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $537.03 Median $676.08 Typical High $794.33 | Professional | 22 · Increased work | $537.03 | $676.08 | $794.33 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $831.76 Typical High $1,000.00 | Professional | 50 · Both sides | $676.08 | $831.76 | $1,000.00 |
Where North Dakota sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 6th of 51
$513
AK $1,023UT $191
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.