How much rates vary
Facilitymedian $324 · 10th to 90th $257 to $2,570Professionalmedian $537 · 10th to 90th $275 to $794
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 $257.04 Median $316.23 Typical High $323.59 | Facility | None | $257.04 | $316.23 | $323.59 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | 54 · Surgery only | $190.55 | $190.55 | $245.47 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $371.54 | Professional | None | $257.04 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $218.78 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $794.33 | Professional | None | $457.09 | $602.56 | $794.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $549.54 Median $724.44 Typical High $954.99 | Professional | 22 · Increased work | $549.54 | $724.44 | $954.99 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $316.23 | $426.58 | $562.34 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $457.09 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $338.84 | $457.09 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $645.65 | Facility | None | $562.34 | $562.34 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $575.44 Typical High $870.96 | Professional | None | $281.84 | $575.44 | $870.96 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $467.74 Typical High $2,511.89 | Facility | None | $257.04 | $467.74 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $575.44 Typical High $2,454.71 | Professional | None | $275.42 | $575.44 | $2,454.71 |
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 $234.42 Median $407.38 Typical High $645.65 | Professional | None | $234.42 | $407.38 | $645.65 |
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 $128.82 Median $128.82 Typical High $162.18 | Facility | 52 · Reduced service | $128.82 | $128.82 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $66.07 | Facility | 53 · Discontinued | $51.29 | $51.29 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $48.98 | Facility | 55 · Aftercare only | $38.02 | $38.02 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $32.36 | Facility | 56 · Pre-op care only | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $37.15 |
Where North Dakota sits
The same service costs 8.7 times more in Alaska than in North Dakota. 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 $7,504ND $861
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.