How much rates vary
Facilitymedian $123 · 10th to 90th $120 to $269Professionalmedian $251 · 10th to 90th $123 to $324
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 $120.23 Median $123.03 Typical High $123.03 | Facility | None | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | None | $109.65 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $91.20 Typical High $97.72 | Professional | 54 · Surgery only | $89.13 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $85.11 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $83.18 | $85.11 | $91.20 |
BCBS North Dakota Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $331.13 | Professional | None | $229.09 | $275.42 | $331.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $275.42 Median $331.13 Typical High $398.11 | Professional | 22 · Increased work | $275.42 | $331.13 | $398.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $158.49 | $194.98 | $234.42 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $27.54 Typical High $33.11 | Professional | 56 · Pre-op care only | $22.91 | $27.54 | $33.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $251.19 | Facility | None | $218.78 | $218.78 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $398.11 | Professional | None | $120.23 | $245.47 | $398.11 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $269.15 | Facility | None | $120.23 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $933.25 | Professional | None | $125.89 | $234.42 | $933.25 |
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 $123.03 Median $223.87 Typical High $269.15 | Professional | None | $123.03 | $223.87 | $269.15 |
3 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 Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $60.26 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $23.99 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $19.50 |
Where North Dakota sits
The same service costs 5.1 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· 6th of 51
$251
AK $501UT $97.72
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.