How much rates vary
Facilitymedian $347 · 10th to 90th $186 to $2,570Professionalmedian $468 · 10th to 90th $309 to $794
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 $338.84 Typical High $346.74 | Facility | None | $186.21 | $338.84 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $263.03 | Facility | 54 · Surgery only | $138.04 | $141.25 | $263.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $34.67 | Facility | 56 · Pre-op care only | $18.62 | $19.05 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $131.83 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $128.82 | $131.83 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $346.74 | Professional | None | $186.21 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $158.49 | $245.47 |
BCBS North Dakota Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $794.33 | Professional | None | $346.74 | $489.78 | $794.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $416.87 Median $588.84 Typical High $933.25 | Professional | 22 · Increased work | $416.87 | $588.84 | $933.25 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $741.31 Typical High $1,174.90 | Professional | 50 · Both sides | $524.81 | $741.31 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $346.74 Typical High $549.54 | Professional | 54 · Surgery only | $245.47 | $346.74 | $549.54 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $48.98 Typical High $79.43 | Professional | 56 · Pre-op care only | $34.67 | $48.98 | $79.43 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $371.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $263.03 | $371.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $676.08 | Facility | None | $575.44 | $575.44 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $912.01 | Professional | None | $275.42 | $512.86 | $912.01 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $478.63 Typical High $2,511.89 | Facility | None | $186.21 | $478.63 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $660.69 Typical High $1,380.38 | Professional | None | $354.81 | $660.69 | $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 $707.95 | Professional | None | $190.55 | $371.54 | $707.95 |
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 $91.20 Median $93.33 Typical High $173.78 | Facility | 52 · Reduced service | $91.20 | $93.33 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $69.18 | Facility | 53 · Discontinued | $37.15 | $38.02 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $52.48 | Facility | 55 · Aftercare only | $27.54 | $28.18 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $91.20 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $34.67 | $52.48 |
Where North Dakota sits
The same service costs 5.1 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· 10th of 51
$468
AK $977TX $191
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.