How much rates vary
Facilitymedian $316 · 10th to 90th $182 to $708Professionalmedian $692 · 10th to 90th $316 to $933
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 $316.23 Median $331.13 Typical High $1,258.93 | Facility | None | $316.23 | $331.13 | $1,258.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $251.19 | Facility | 54 · Surgery only | $239.88 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $33.11 | Facility | 56 · Pre-op care only | $31.62 | $33.11 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $234.42 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $602.56 | Professional | None | $239.88 | $316.23 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $223.87 | $234.42 | $251.19 |
BCBS North Dakota Setting Facility Modifier None Typical Low $239.88 Median $524.81 Typical High $724.44 | Facility | None | $239.88 | $524.81 | $724.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $933.25 | Professional | None | $630.96 | $776.25 | $933.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $741.31 Median $933.25 Typical High $1,122.02 | Professional | 22 · Increased work | $741.31 | $933.25 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,174.90 Typical High $1,412.54 | Professional | 50 · Both sides | $933.25 | $1,174.90 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $436.52 | $549.54 | $660.69 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $93.33 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $467.74 | $588.84 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Facility | None | $616.60 | $616.60 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $1,096.48 | Professional | None | $323.59 | $741.31 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $316.23 Typical High $562.34 | Facility | None | $125.89 | $316.23 | $562.34 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $2,511.89 | Professional | None | $346.74 | $645.65 | $2,511.89 |
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 $323.59 Median $575.44 Typical High $707.95 | Professional | None | $323.59 | $575.44 | $707.95 |
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 $158.49 Median $165.96 Typical High $165.96 | Facility | 52 · Reduced service | $158.49 | $165.96 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $66.07 | Facility | 53 · Discontinued | $63.10 | $66.07 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $50.12 | Facility | 55 · Aftercare only | $47.86 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $158.49 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $63.10 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $54.95 |
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
$676
AK $1,380TX $245
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.