How much rates vary
Facilitymedian $269 · 10th to 90th $170 to $1,202Professionalmedian $363 · 10th to 90th $186 to $617
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 $169.82 Median $245.47 Typical High $269.15 | Facility | None | $169.82 | $245.47 | $269.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $204.17 | Facility | 54 · Surgery only | $128.82 | $128.82 | $204.17 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $120.23 | $120.23 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $323.59 | Professional | None | $162.18 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $173.78 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $173.78 | $190.55 |
BCBS North Dakota Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $630.96 | Professional | None | $302.00 | $426.58 | $630.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $354.81 Median $501.19 Typical High $758.58 | Professional | 22 · Increased work | $354.81 | $501.19 | $758.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $295.12 Typical High $446.68 | Professional | 54 · Surgery only | $208.93 | $295.12 | $446.68 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $223.87 | $316.23 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Facility | None | $446.68 | $446.68 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $398.11 Typical High $645.65 | Professional | None | $199.53 | $398.11 | $645.65 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $1,096.48 | Facility | None | $169.82 | $302.00 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $501.19 Typical High $1,862.09 | Professional | None | $229.09 | $501.19 | $1,862.09 |
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 $169.82 Median $302.00 Typical High $537.03 | Professional | None | $169.82 | $302.00 | $537.03 |
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 $85.11 Median $85.11 Typical High $134.90 | Facility | 52 · Reduced service | $85.11 | $85.11 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $53.70 | Facility | 53 · Discontinued | $33.88 | $33.88 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $40.74 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $26.92 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $83.18 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $26.92 |
Where North Dakota sits
The same service costs 3.6 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· 11th of 51
$363
AK $646TX $178
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.