How much rates vary
Facilitymedian $295 · 10th to 90th $182 to $589Professionalmedian $646 · 10th to 90th $324 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 $295.12 Median $323.59 Typical High $645.65 | Facility | None | $295.12 | $323.59 | $645.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $239.88 | Facility | 54 · Surgery only | $223.87 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $32.36 | Facility | 56 · Pre-op care only | $29.51 | $31.62 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Professional | None | $269.15 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $223.87 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $239.88 |
BCBS North Dakota Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $891.25 | Professional | None | $588.84 | $741.31 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $891.25 Typical High $1,071.52 | Professional | 22 · Increased work | $707.95 | $891.25 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $1,348.96 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $512.86 | $630.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $74.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $58.88 | $74.13 | $89.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $676.08 |
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 $331.13 Median $691.83 Typical High $1,000.00 | Professional | None | $331.13 | $691.83 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $295.12 Typical High $562.34 | Facility | None | $134.90 | $295.12 | $562.34 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $602.56 Typical High $2,290.87 | Professional | None | $331.13 | $602.56 | $2,290.87 |
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 $309.03 Median $562.34 Typical High $660.69 | Professional | None | $309.03 | $562.34 | $660.69 |
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 $147.91 Median $158.49 Typical High $162.18 | Facility | 52 · Reduced service | $147.91 | $158.49 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $64.57 | Facility | 53 · Discontinued | $58.88 | $63.10 | $64.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $48.98 | Facility | 55 · Aftercare only | $44.67 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $158.49 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $51.29 |
Where North Dakota sits
The same service costs 5.8 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
$631
AK $1,259UT $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.