How much rates vary
Facilitymedian $1,318 · 10th to 90th $372 to $3,236Professionalmedian $1,318 · 10th to 90th $646 to $3,162
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 $371.54 Median $1,318.26 Typical High $1,318.26 | Facility | None | $371.54 | $1,318.26 | $1,318.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $1,000.00 | Facility | 54 · Surgery only | $281.84 | $309.03 | $1,000.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $933.25 | Facility | 78 · Unplanned return to OR | $263.03 | $288.40 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,445.44 | Professional | None | $371.54 | $562.34 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $3,235.94 | Professional | None | $724.44 | $1,096.48 | $3,235.94 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $870.96 Median $1,288.25 Typical High $3,890.45 | Professional | 22 · Increased work | $870.96 | $1,288.25 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,621.81 Typical High $4,897.79 | Professional | 50 · Both sides | $1,096.48 | $1,621.81 | $4,897.79 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $2,290.87 | Professional | 54 · Surgery only | $512.86 | $758.58 | $2,290.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,344.23 | Facility | None | $2,041.74 | $2,041.74 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $3,715.35 | Professional | None | $537.03 | $1,122.02 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $3,235.94 | Facility | None | $371.54 | $1,698.24 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,905.46 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,122.02 Typical High $2,398.83 | Professional | None | $398.11 | $1,122.02 | $2,398.83 |
4 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 $186.21 Median $204.17 Typical High $660.69 | Facility | 52 · Reduced service | $186.21 | $204.17 | $660.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $263.03 | Facility | 53 · Discontinued | $74.13 | $81.28 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $199.53 | Facility | 55 · Aftercare only | $56.23 | $61.66 | $199.53 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $131.83 | Facility | 56 · Pre-op care only | $37.15 | $40.74 | $131.83 |
Where North Dakota sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 35th of 51
$1,318
AK $3,020NE $692
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.