How much rates vary
Facilitymedian $224 · 10th to 90th $117 to $380Professionalmedian $282 · 10th to 90th $155 to $562
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 $117.49 Median $223.87 Typical High $223.87 | Facility | None | $117.49 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $165.96 | Facility | 54 · Surgery only | $87.10 | $87.10 | $165.96 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $81.28 | $81.28 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $239.88 | Professional | None | $117.49 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $165.96 Typical High $177.83 | Professional | 54 · Surgery only | $87.10 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $154.88 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $81.28 | $154.88 | $165.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $562.34 | Professional | None | $223.87 | $338.84 | $562.34 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $269.15 Median $407.38 Typical High $676.08 | Professional | 22 · Increased work | $269.15 | $407.38 | $676.08 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $239.88 Typical High $389.05 | Professional | 54 · Surgery only | $154.88 | $239.88 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $257.04 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $165.96 | $257.04 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Facility | None | $398.11 | $398.11 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $588.84 | Professional | None | $154.88 | $323.59 | $588.84 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $380.19 | Facility | None | $117.49 | $223.87 | $380.19 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $1,698.24 | Professional | None | $186.21 | $416.87 | $1,698.24 |
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 $117.49 Median $223.87 Typical High $436.52 | Professional | None | $117.49 | $223.87 | $436.52 |
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 $58.88 Median $58.88 Typical High $109.65 | Facility | 52 · Reduced service | $58.88 | $58.88 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $44.67 | Facility | 53 · Discontinued | $23.44 | $23.44 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $33.11 | Facility | 55 · Aftercare only | $17.38 | $17.38 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $22.39 | Facility | 56 · Pre-op care only | $11.75 | $11.75 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $58.88 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $23.44 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $33.11 Typical High $35.48 | Professional | 55 · Aftercare only | $17.38 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.75 | $22.39 | $23.99 |
Where North Dakota sits
The same service costs 3.5 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· 12th of 51
$269
AK $468TX $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.