How much rates vary
Facilitymedian $457 · 10th to 90th $347 to $2,570Professionalmedian $759 · 10th to 90th $372 to $1,175
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 $346.74 Median $457.09 Typical High $457.09 | Facility | None | $346.74 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $346.74 | Facility | 54 · Surgery only | $263.03 | $263.03 | $346.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $45.71 | Facility | 56 · Pre-op care only | $34.67 | $34.67 | $45.71 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $245.47 | $245.47 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $977.24 | Professional | None | $346.74 | $457.09 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $346.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,174.90 | Professional | None | $645.65 | $870.96 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $776.25 Median $1,047.13 Typical High $1,412.54 | Professional | 22 · Increased work | $776.25 | $1,047.13 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $602.56 Typical High $831.76 | Professional | 54 · Surgery only | $457.09 | $602.56 | $831.76 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $87.10 Typical High $117.49 | Professional | 56 · Pre-op care only | $64.57 | $87.10 | $117.49 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $645.65 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $489.78 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Facility | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $794.33 Typical High $1,202.26 | Professional | None | $371.54 | $794.33 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $660.69 Typical High $2,511.89 | Facility | None | $346.74 | $660.69 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $812.83 Typical High $3,467.37 | Professional | None | $389.05 | $812.83 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $891.25 | Professional | None | $316.23 | $549.54 | $891.25 |
6 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 $173.78 Median $173.78 Typical High $229.09 | Facility | 52 · Reduced service | $173.78 | $173.78 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $91.20 | Facility | 53 · Discontinued | $69.18 | $69.18 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $69.18 | Facility | 55 · Aftercare only | $52.48 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $173.78 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $74.13 |
Where North Dakota sits
The same service costs 6.4 times more in Alaska than in Montana. 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 $7,722MT $1,208
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.