How much rates vary
Facilitymedian $398 · 10th to 90th $257 to $2,512Professionalmedian $589 · 10th to 90th $363 to $912
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 $257.04 Median $389.05 Typical High $398.11 | Facility | None | $257.04 | $389.05 | $398.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $302.00 | Facility | 54 · Surgery only | $190.55 | $194.98 | $302.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $39.81 | Facility | 56 · Pre-op care only | $25.70 | $25.70 | $39.81 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $181.97 Typical High $281.84 | Facility | 78 · Unplanned return to OR | $177.83 | $181.97 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $446.68 | Professional | None | $257.04 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $190.55 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $223.87 | $281.84 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $912.01 | Professional | None | $478.63 | $645.65 | $912.01 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $575.44 Median $776.25 Typical High $1,096.48 | Professional | 22 · Increased work | $575.44 | $776.25 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $977.24 Typical High $1,380.38 | Professional | 50 · Both sides | $724.44 | $977.24 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $457.09 Typical High $645.65 | Professional | 54 · Surgery only | $331.13 | $457.09 | $645.65 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $64.57 Typical High $91.20 | Professional | 56 · Pre-op care only | $47.86 | $64.57 | $91.20 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $489.78 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $354.81 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,047.13 | Professional | None | $389.05 | $645.65 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $676.08 Typical High $2,511.89 | Facility | None | $257.04 | $676.08 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $758.58 Typical High $1,905.46 | Professional | None | $407.38 | $758.58 | $1,905.46 |
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 $263.03 Median $489.78 Typical High $812.83 | Professional | None | $263.03 | $489.78 | $812.83 |
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 $128.82 Median $128.82 Typical High $199.53 | Facility | 52 · Reduced service | $128.82 | $128.82 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $79.43 | Facility | 53 · Discontinued | $51.29 | $51.29 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $60.26 | Facility | 55 · Aftercare only | $38.02 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $47.86 Typical High $60.26 | Professional | 55 · Aftercare only | $38.02 | $47.86 | $60.26 |
Where North Dakota sits
The same service costs 4.3 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
$575
AK $1,023TX $240
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.