How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $479Professionalmedian $363 · 10th to 90th $219 to $871
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 $138.04 Median $309.03 Typical High $309.03 | Facility | None | $138.04 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $107.15 Typical High $229.09 | Facility | 54 · Surgery only | $104.71 | $107.15 | $229.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $100.00 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $97.72 | $100.00 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $416.87 | Professional | None | $134.90 | $223.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $131.83 Typical High $251.19 | Professional | 54 · Surgery only | $104.71 | $131.83 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $123.03 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $97.72 | $123.03 | $234.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $891.25 | Professional | None | $288.40 | $426.58 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $512.86 Typical High $1,071.52 | Professional | 22 · Increased work | $346.74 | $512.86 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $302.00 Typical High $616.60 | Professional | 54 · Surgery only | $204.17 | $302.00 | $616.60 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $323.59 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $218.78 | $323.59 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $676.08 | Facility | None | $588.84 | $588.84 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $933.25 | Professional | None | $208.93 | $389.05 | $933.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $478.63 | Facility | None | $125.89 | $251.19 | $478.63 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $1,288.25 | Professional | None | $309.03 | $537.03 | $1,288.25 |
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 $144.54 Median $309.03 Typical High $588.84 | Professional | None | $144.54 | $309.03 | $588.84 |
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 $69.18 Median $70.79 Typical High $151.36 | Facility | 52 · Reduced service | $69.18 | $70.79 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $28.84 Typical High $61.66 | Facility | 53 · Discontinued | $27.54 | $28.84 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $45.71 | Facility | 55 · Aftercare only | $20.89 | $21.38 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $30.90 | Facility | 56 · Pre-op care only | $13.80 | $14.45 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $87.10 Typical High $169.82 | Professional | 52 · Reduced service | $69.18 | $87.10 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $34.67 Typical High $67.61 | Professional | 53 · Discontinued | $27.54 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.30 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $26.30 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.80 | $17.38 | $33.88 |
Where North Dakota sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 10th of 51
$339
WI $603KY $166
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.