How much rates vary
Facilitymedian $479 · 10th to 90th $316 to $1,445Professionalmedian $692 · 10th to 90th $407 to $1,122
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 $316.23 Median $467.74 Typical High $478.63 | Facility | None | $316.23 | $467.74 | $478.63 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $354.81 | Facility | 54 · Surgery only | $239.88 | $239.88 | $354.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $47.86 | Facility | 56 · Pre-op care only | $31.62 | $31.62 | $47.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $223.87 | $223.87 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $524.81 | Professional | None | $295.12 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $354.81 | Professional | 54 · Surgery only | $239.88 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $331.13 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,344.23 | Facility | None | $1,412.54 | $1,412.54 | $2,344.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,122.02 | Professional | None | $588.84 | $794.33 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $954.99 Typical High $1,318.26 | Professional | 22 · Increased work | $707.95 | $954.99 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,202.26 Typical High $1,659.59 | Professional | 50 · Both sides | $870.96 | $1,202.26 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $407.38 | $562.34 | $776.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $79.43 Typical High $112.20 | Professional | 56 · Pre-op care only | $58.88 | $79.43 | $112.20 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $602.56 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $436.52 | $602.56 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Facility | None | $794.33 | $794.33 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,258.93 | Professional | None | $446.68 | $776.25 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $660.69 Typical High $1,445.44 | Facility | None | $316.23 | $660.69 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $2,344.23 | Professional | None | $489.78 | $891.25 | $2,344.23 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $954.99 | Professional | None | $323.59 | $602.56 | $954.99 |
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 $158.49 Median $158.49 Typical High $239.88 | Facility | 52 · Reduced service | $158.49 | $158.49 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $95.50 | Facility | 53 · Discontinued | $63.10 | $63.10 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $72.44 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $72.44 |
Where North Dakota sits
The same service costs 4.9 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· 8th of 51
$692
AK $1,413UT $288
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.