How much rates vary
Facilitymedian $347 · 10th to 90th $186 to $2,570Professionalmedian $457 · 10th to 90th $275 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 $186.21 Median $331.13 Typical High $346.74 | Facility | None | $186.21 | $331.13 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $263.03 | Facility | 54 · Surgery only | $141.25 | $141.25 | $263.03 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $131.83 | $131.83 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $398.11 | Professional | None | $173.78 | $288.40 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $165.96 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $165.96 | $245.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $812.83 | Professional | None | $346.74 | $512.86 | $812.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $416.87 Median $616.60 Typical High $977.24 | Professional | 22 · Increased work | $416.87 | $616.60 | $977.24 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $776.25 Typical High $1,230.27 | Professional | 50 · Both sides | $512.86 | $776.25 | $1,230.27 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $363.08 Typical High $575.44 | Professional | 54 · Surgery only | $239.88 | $363.08 | $575.44 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $389.05 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $257.04 | $389.05 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Facility | None | $575.44 | $575.44 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $891.25 | Professional | None | $275.42 | $501.19 | $891.25 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $467.74 Typical High $2,511.89 | Facility | None | $186.21 | $467.74 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $1,380.38 | Professional | None | $354.81 | $645.65 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $691.83 | Professional | None | $190.55 | $371.54 | $691.83 |
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 $93.33 Median $93.33 Typical High $173.78 | Facility | 52 · Reduced service | $93.33 | $93.33 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $69.18 | Facility | 53 · Discontinued | $37.15 | $37.15 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $52.48 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $34.67 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $117.49 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $34.67 |
Where North Dakota sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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.
Physician feeFacility fee
OK $5,125ND $804
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.