How much rates vary
Facilitymedian $6,457 · 10th to 90th $513 to $10,000Professionalmedian $6,607 · 10th to 90th $776 to $13,804
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 $512.86 Median $6,025.60 Typical High $6,456.54 | Facility | None | $512.86 | $6,025.60 | $6,456.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $4,897.79 | Facility | 54 · Surgery only | $380.19 | $407.38 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $6,918.31 | Professional | None | $501.19 | $660.69 | $6,918.31 |
BCBS North Dakota Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $14,454.40 | Professional | None | $891.25 | $1,318.26 | $14,454.40 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,071.52 Median $1,584.89 Typical High $17,378.01 | Professional | 22 · Increased work | $1,071.52 | $1,584.89 | $17,378.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $933.25 Typical High $10,000.00 | Professional | 54 · Surgery only | $616.60 | $933.25 | $10,000.00 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,000.00 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $660.69 | $1,000.00 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,471.29 | Facility | None | $9,120.11 | $9,120.11 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $7,762.47 Typical High $16,218.10 | Professional | None | $707.95 | $7,762.47 | $16,218.10 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $6,456.54 Typical High $11,481.54 | Facility | None | $512.86 | $6,456.54 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $6,606.93 Median $12,882.50 Typical High $14,125.38 | Professional | None | $6,606.93 | $12,882.50 | $14,125.38 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $8,709.64 Typical High $28,840.32 | Facility | None | $5,623.41 | $8,709.64 | $28,840.32 |
United Setting Professional Modifier None Typical Low $537.03 Median $6,025.60 Typical High $13,803.84 | Professional | None | $537.03 | $6,025.60 | $13,803.84 |
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 $257.04 Median $269.15 Typical High $3,235.94 | Facility | 52 · Reduced service | $257.04 | $269.15 | $3,235.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $1,318.26 | Facility | 53 · Discontinued | $102.33 | $107.15 | $1,318.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $977.24 | Facility | 55 · Aftercare only | $75.86 | $81.28 | $977.24 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $645.65 | Facility | 56 · Pre-op care only | $51.29 | $53.70 | $645.65 |
Where North Dakota sits
The same service costs 6.1 times more in Alaska than in Vermont. 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.
Physician feeFacility fee
AK $33,081VT $5,424
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.