How much rates vary
Facilitymedian $479 · 10th to 90th $182 to $871Professionalmedian $1,023 · 10th to 90th $513 to $1,380
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 $478.63 Median $512.86 Typical High $512.86 | Facility | None | $478.63 | $512.86 | $512.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $380.19 | Facility | 54 · Surgery only | $354.81 | $371.54 | $380.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $51.29 | Facility | 56 · Pre-op care only | $47.86 | $50.12 | $51.29 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $331.13 | $346.74 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $537.03 | Professional | None | $426.58 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $371.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,380.38 | Professional | None | $912.01 | $1,148.15 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,096.48 Median $1,380.38 Typical High $1,659.59 | Professional | 22 · Increased work | $1,096.48 | $1,380.38 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,089.30 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,089.30 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $630.96 | $794.33 | $977.24 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $114.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $91.20 | $114.82 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $691.83 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Facility | None | $912.01 | $912.01 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,548.82 | Professional | None | $512.86 | $1,071.52 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $478.63 Typical High $870.96 | Facility | None | $134.90 | $478.63 | $870.96 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $3,630.78 | Professional | None | $537.03 | $1,000.00 | $3,630.78 |
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 $501.19 Median $891.25 Typical High $1,071.52 | Professional | None | $501.19 | $891.25 | $1,071.52 |
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 $239.88 Median $251.19 Typical High $257.04 | Facility | 52 · Reduced service | $239.88 | $251.19 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $102.33 | Facility | 53 · Discontinued | $95.50 | $100.00 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $75.86 | Facility | 55 · Aftercare only | $72.44 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $95.50 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $81.28 |
Where North Dakota sits
The same service costs 5.8 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
$1,000
AK $2,042TX $355
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.