How much rates vary
Facilitymedian $224 · 10th to 90th $132 to $1,202Professionalmedian $288 · 10th to 90th $141 to $550
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 $131.83 Median $223.87 Typical High $223.87 | Facility | None | $131.83 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $165.96 | Facility | 54 · Surgery only | $97.72 | $97.72 | $165.96 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $91.20 | $91.20 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $380.19 | Professional | None | $128.82 | $208.93 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $97.72 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $91.20 | $154.88 | $169.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $549.54 | Professional | None | $234.42 | $346.74 | $549.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $281.84 Median $416.87 Typical High $660.69 | Professional | 22 · Increased work | $281.84 | $416.87 | $660.69 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $389.05 | Professional | 54 · Surgery only | $165.96 | $239.88 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $257.04 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $177.83 | $257.04 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $457.09 | Facility | None | $398.11 | $398.11 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $575.44 | Professional | None | $173.78 | $338.84 | $575.44 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $229.09 Typical High $1,096.48 | Facility | None | $131.83 | $229.09 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $1,698.24 | Professional | None | $186.21 | $389.05 | $1,698.24 |
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 $123.03 Median $239.88 Typical High $426.58 | Professional | None | $123.03 | $239.88 | $426.58 |
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 $66.07 Median $66.07 Typical High $112.20 | Facility | 52 · Reduced service | $66.07 | $66.07 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $44.67 | Facility | 53 · Discontinued | $26.30 | $26.30 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $33.11 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $22.39 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $66.07 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $26.30 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $19.50 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.18 | $22.39 | $23.99 |
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
$282
AK $525DC $158
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.