How much rates vary
Facilitymedian $282 · 10th to 90th $135 to $490Professionalmedian $617 · 10th to 90th $288 to $813
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 $281.84 Median $295.12 Typical High $309.03 | Facility | None | $281.84 | $295.12 | $309.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $223.87 | Facility | 54 · Surgery only | $213.80 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $29.51 | Facility | 56 · Pre-op care only | $28.18 | $29.51 | $29.51 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $524.81 | Professional | None | $245.47 | $295.12 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $223.87 |
BCBS North Dakota Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
BCBS North Dakota Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $831.76 | Professional | None | $549.54 | $691.83 | $831.76 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $660.69 Median $831.76 Typical High $1,000.00 | Professional | 22 · Increased work | $660.69 | $831.76 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $478.63 | $575.44 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $83.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Facility | None | $549.54 | $549.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $660.69 Typical High $954.99 | Professional | None | $288.40 | $660.69 | $954.99 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $281.84 Typical High $501.19 | Facility | None | $125.89 | $281.84 | $501.19 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $2,187.76 | Professional | None | $309.03 | $588.84 | $2,187.76 |
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 $288.40 Median $512.86 Typical High $630.96 | Professional | None | $288.40 | $512.86 | $630.96 |
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 $141.25 Median $147.91 Typical High $147.91 | Facility | 52 · Reduced service | $141.25 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $60.26 | Facility | 53 · Discontinued | $56.23 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $44.67 | Facility | 55 · Aftercare only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $47.86 |
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
$603
AK $1,230TX $219
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.