How much rates vary
Facilitymedian $263 · 10th to 90th $135 to $490Professionalmedian $589 · 10th to 90th $275 to $776
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 $257.04 Median $288.40 Typical High $288.40 | Facility | None | $257.04 | $288.40 | $288.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $213.80 | Facility | 54 · Surgery only | $190.55 | $208.93 | $213.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $28.84 | Facility | 56 · Pre-op care only | $25.70 | $27.54 | $28.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $177.83 | $194.98 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $323.59 | Professional | None | $229.09 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $190.55 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $218.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $794.33 | Professional | None | $524.81 | $660.69 | $794.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $630.96 Median $794.33 Typical High $954.99 | Professional | 22 · Increased work | $630.96 | $794.33 | $954.99 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $363.08 | $467.74 | $562.34 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $79.43 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $501.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $389.05 | $501.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $616.60 | Facility | None | $524.81 | $524.81 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $588.84 Typical High $851.14 | Professional | None | $281.84 | $588.84 | $851.14 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $489.78 | Facility | None | $125.89 | $263.03 | $489.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $1,995.26 | Professional | None | $295.12 | $549.54 | $1,995.26 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $575.44 | Professional | None | $263.03 | $489.78 | $575.44 |
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 $128.82 Median $138.04 Typical High $141.25 | Facility | 52 · Reduced service | $128.82 | $138.04 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $57.54 | Facility | 53 · Discontinued | $51.29 | $54.95 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $42.66 | Facility | 55 · Aftercare only | $38.02 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $128.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $51.29 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $46.77 |
Where North Dakota sits
The same service costs 5.4 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
$550
AK $1,096TX $204
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.