How much rates vary
Facilitymedian $708 · 10th to 90th $170 to $1,698Professionalmedian $708 · 10th to 90th $200 to $1,862
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 $169.82 Median $707.95 Typical High $794.33 | Facility | None | $169.82 | $707.95 | $794.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $524.81 | Facility | 54 · Surgery only | $125.89 | $134.90 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $524.81 Typical High $1,096.48 | Professional | None | $151.36 | $524.81 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $223.87 Typical High $588.84 | Professional | 54 · Surgery only | $125.89 | $223.87 | $588.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $1,659.59 | Professional | None | $295.12 | $457.09 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $354.81 Median $549.54 Typical High $1,995.26 | Professional | 22 · Increased work | $354.81 | $549.54 | $1,995.26 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $323.59 Typical High $1,174.90 | Professional | 54 · Surgery only | $204.17 | $323.59 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $346.74 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $218.78 | $346.74 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Facility | None | $1,202.26 | $1,202.26 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $537.03 Typical High $1,621.81 | Professional | None | $190.55 | $537.03 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $707.95 Typical High $1,698.24 | Facility | None | $169.82 | $707.95 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,862.09 Typical High $5,128.61 | Professional | None | $707.95 | $1,862.09 | $5,128.61 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $177.83 Median $588.84 Typical High $1,258.93 | Professional | None | $177.83 | $588.84 | $1,258.93 |
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 $83.18 Median $89.13 Typical High $354.81 | Facility | 52 · Reduced service | $83.18 | $89.13 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $141.25 | Facility | 53 · Discontinued | $33.88 | $35.48 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $104.71 | Facility | 55 · Aftercare only | $25.12 | $26.92 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $70.79 | Facility | 56 · Pre-op care only | $16.98 | $17.78 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $151.36 Typical High $389.05 | Professional | 52 · Reduced service | $83.18 | $151.36 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $60.26 Typical High $158.49 | Professional | 53 · Discontinued | $33.88 | $60.26 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $44.67 Typical High $117.49 | Professional | 55 · Aftercare only | $25.12 | $44.67 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.20 Typical High $79.43 | Professional | 56 · Pre-op care only | $16.98 | $30.20 | $79.43 |
Where North Dakota sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 11th of 51
$708
WI $1,148HI $219
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.