How much rates vary
Facilitymedian $389 · 10th to 90th $182 to $759Professionalmedian $851 · 10th to 90th $427 to $1,175
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 $389.05 Median $426.58 Typical High $426.58 | Facility | None | $389.05 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $323.59 | Facility | 54 · Surgery only | $295.12 | $309.03 | $323.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $42.66 | Facility | 56 · Pre-op care only | $38.90 | $40.74 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $275.42 | $288.40 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $457.09 | Professional | None | $354.81 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,174.90 | Professional | None | $758.58 | $954.99 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $831.76 | Professional | 54 · Surgery only | $537.03 | $660.69 | $831.76 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $117.49 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Facility | None | $776.25 | $776.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $1,288.25 | Professional | None | $436.52 | $891.25 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $389.05 Typical High $758.58 | Facility | None | $134.90 | $389.05 | $758.58 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $3,019.95 | Professional | None | $446.68 | $831.76 | $3,019.95 |
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 $407.38 Median $741.31 Typical High $870.96 | Professional | None | $407.38 | $741.31 | $870.96 |
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 $194.98 Median $204.17 Typical High $213.80 | Facility | 52 · Reduced service | $194.98 | $204.17 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $85.11 | Facility | 53 · Discontinued | $77.62 | $81.28 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $64.57 | Facility | 55 · Aftercare only | $58.88 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $67.61 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $912.01 Median $1,148.15 Typical High $1,412.54 | Professional | 22 · Increased work | $912.01 | $1,148.15 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,445.44 Typical High $1,778.28 | Professional | 50 · Both sides | $1,148.15 | $1,445.44 | $1,778.28 |
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· 7th of 51
$851
AK $1,738UT $324
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.