How much rates vary
Facilitymedian $214 · 10th to 90th $110 to $1,585Professionalmedian $251 · 10th to 90th $123 to $513
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 $109.65 Median $213.80 Typical High $213.80 | Facility | None | $109.65 | $213.80 | $213.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $158.49 | Facility | 54 · Surgery only | $81.28 | $81.28 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $363.08 | Professional | None | $109.65 | $208.93 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $81.28 | $154.88 | $169.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $512.86 | Professional | None | $204.17 | $316.23 | $512.86 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $380.19 Typical High $616.60 | Professional | 22 · Increased work | $245.47 | $380.19 | $616.60 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $354.81 | Professional | 54 · Surgery only | $144.54 | $218.78 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Facility | None | $371.54 | $371.54 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $302.00 Typical High $549.54 | Professional | None | $141.25 | $302.00 | $549.54 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $323.59 Typical High $1,479.11 | Facility | None | $109.65 | $323.59 | $1,479.11 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $371.54 Typical High $1,621.81 | Professional | None | $177.83 | $371.54 | $1,621.81 |
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 $102.33 Median $213.80 Typical High $407.38 | Professional | None | $102.33 | $213.80 | $407.38 |
10 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 $54.95 Median $54.95 Typical High $107.15 | Facility | 52 · Reduced service | $54.95 | $54.95 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $42.66 | Facility | 53 · Discontinued | $21.88 | $21.88 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $31.62 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $21.38 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $21.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $75.86 | $75.86 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $54.95 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $21.88 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $16.22 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.96 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $144.54 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $75.86 | $144.54 | $158.49 |
Where North Dakota sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$251
AK $447DC $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.