How much rates vary
Facilitymedian $282 · 10th to 90th $178 to $759Professionalmedian $417 · 10th to 90th $257 to $676
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 $177.83 Median $275.42 Typical High $281.84 | Facility | None | $177.83 | $275.42 | $281.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $208.93 | Facility | 54 · Surgery only | $131.83 | $131.83 | $208.93 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $123.03 | $123.03 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $309.03 | Professional | None | $177.83 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $131.83 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $154.88 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $123.03 | $154.88 | $194.98 |
BCBS North Dakota Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $380.19 Median $537.03 Typical High $794.33 | Professional | 22 · Increased work | $380.19 | $537.03 | $794.33 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $676.08 Typical High $1,000.00 | Professional | 50 · Both sides | $467.74 | $676.08 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $316.23 Typical High $467.74 | Professional | 54 · Surgery only | $218.78 | $316.23 | $467.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $234.42 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $741.31 | Professional | None | $251.19 | $436.52 | $741.31 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $758.58 | Facility | None | $177.83 | $346.74 | $758.58 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,318.26 | Professional | None | $288.40 | $512.86 | $1,318.26 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $537.03 | Professional | None | $181.97 | $338.84 | $537.03 |
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 $89.13 Median $89.13 Typical High $138.04 | Facility | 52 · Reduced service | $89.13 | $89.13 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $56.23 | Facility | 53 · Discontinued | $35.48 | $35.48 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $41.69 | Facility | 55 · Aftercare only | $26.30 | $26.30 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $28.18 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $89.13 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $35.48 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.78 | $21.88 | $28.18 |
Where North Dakota sits
The same service costs 4.1 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· 8th of 51
$407
AK $851TX $209
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.