How much rates vary
Facilitymedian $347 · 10th to 90th $209 to $2,570Professionalmedian $479 · 10th to 90th $257 to $891
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 $208.93 Median $346.74 Typical High $346.74 | Facility | None | $208.93 | $346.74 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $263.03 | Facility | 54 · Surgery only | $158.49 | $158.49 | $263.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $34.67 | Facility | 56 · Pre-op care only | $20.89 | $21.38 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $389.05 | Professional | None | $208.93 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $158.49 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.89 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $147.91 | $245.47 | $275.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $891.25 | Professional | None | $389.05 | $575.44 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $691.83 Typical High $1,071.52 | Professional | 22 · Increased work | $467.74 | $691.83 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $407.38 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $407.38 | $630.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $57.54 Typical High $89.13 | Professional | 56 · Pre-op care only | $38.90 | $57.54 | $89.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $436.52 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $295.12 | $436.52 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $549.54 Typical High $954.99 | Professional | None | $234.42 | $549.54 | $954.99 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $537.03 Typical High $2,511.89 | Facility | None | $208.93 | $537.03 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $2,818.38 | Professional | None | $309.03 | $575.44 | $2,818.38 |
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 $199.53 Median $371.54 Typical High $645.65 | Professional | None | $199.53 | $371.54 | $645.65 |
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 $104.71 Median $104.71 Typical High $173.78 | Facility | 52 · Reduced service | $104.71 | $104.71 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $69.18 | Facility | 53 · Discontinued | $41.69 | $42.66 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $52.48 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $104.71 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $41.69 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $31.62 | $52.48 | $58.88 |
Where North Dakota sits
The same service costs 3.7 times more in Wyoming 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
$479
WY $891TX $240
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.