How much rates vary
Facilitymedian $155 · 10th to 90th $132 to $269Professionalmedian $282 · 10th to 90th $155 to $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 $131.83 Median $154.88 Typical High $154.88 | Facility | None | $131.83 | $154.88 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $117.49 | Facility | 54 · Surgery only | $97.72 | $97.72 | $117.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $109.65 | Facility | 78 · Unplanned return to OR | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $158.49 | Professional | None | $128.82 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 54 · Surgery only | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $109.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $380.19 | Professional | None | $239.88 | $295.12 | $380.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $288.40 Median $354.81 Typical High $457.09 | Professional | 22 · Increased work | $288.40 | $354.81 | $457.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $165.96 | $208.93 | $263.03 |
BCBS North Dakota 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 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Facility | None | $269.15 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $416.87 | Professional | None | $158.49 | $288.40 | $416.87 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $389.05 | Facility | None | $131.83 | $181.97 | $389.05 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $954.99 | Professional | None | $158.49 | $295.12 | $954.99 |
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 $134.90 Median $251.19 Typical High $316.23 | Professional | None | $134.90 | $251.19 | $316.23 |
8 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 $64.57 Median $64.57 Typical High $77.62 | Facility | 52 · Reduced service | $64.57 | $64.57 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $30.90 | Facility | 53 · Discontinued | $26.30 | $26.30 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $23.44 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $15.49 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $70.79 Typical High $77.62 | Professional | 52 · Reduced service | $64.57 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.84 Typical High $30.90 | Professional | 53 · Discontinued | $25.70 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $23.44 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.45 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.88 | $14.45 | $15.49 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$275
AK $513DE $135
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.