How much rates vary
Facilitymedian $562 · 10th to 90th $363 to $2,630Professionalmedian $851 · 10th to 90th $468 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 $363.08 Median $562.34 Typical High $562.34 | Facility | None | $363.08 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $416.87 | Facility | 54 · Surgery only | $269.15 | $281.84 | $416.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $56.23 | Facility | 56 · Pre-op care only | $36.31 | $37.15 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $251.19 | $263.03 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $616.60 | Professional | None | $331.13 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $251.19 | $316.23 | $389.05 |
BCBS North Dakota Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
BCBS North Dakota Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,380.38 | Professional | None | $691.83 | $954.99 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $831.76 Median $1,148.15 Typical High $1,659.59 | Professional | 22 · Increased work | $831.76 | $1,148.15 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,412.54 Typical High $2,041.74 | Professional | 50 · Both sides | $1,047.13 | $1,412.54 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $660.69 Typical High $954.99 | Professional | 54 · Surgery only | $489.78 | $660.69 | $954.99 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $95.50 Typical High $138.04 | Professional | 56 · Pre-op care only | $69.18 | $95.50 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $707.95 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $524.81 | $707.95 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $1,513.56 | Professional | None | $537.03 | $933.25 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $2,511.89 | Facility | None | $363.08 | $794.33 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,047.13 Typical High $2,754.23 | Professional | None | $575.44 | $1,047.13 | $2,754.23 |
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 $371.54 Median $691.83 Typical High $1,122.02 | Professional | None | $371.54 | $691.83 | $1,122.02 |
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 $181.97 Median $186.21 Typical High $281.84 | Facility | 52 · Reduced service | $181.97 | $186.21 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $112.20 | Facility | 53 · Discontinued | $72.44 | $74.13 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $83.18 | Facility | 55 · Aftercare only | $54.95 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $72.44 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $83.18 |
Where North Dakota sits
The same service costs 6.4 times more in Alaska than in Montana. 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
AK $8,723MT $1,361
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.