How much rates vary
Facilitymedian $2,455 · 10th to 90th $288 to $5,012Professionalmedian $525 · 10th to 90th $282 to $724
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 $288.40 Median $3,981.07 Typical High $6,456.54 | Facility | None | $288.40 | $3,981.07 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $707.95 | Professional | None | $275.42 | $288.40 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $234.42 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,862.09 Median $7,244.36 Typical High $7,244.36 | Facility | None | $1,862.09 | $7,244.36 | $7,244.36 |
BCBS North Dakota Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $707.95 | Professional | None | $457.09 | $588.84 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $323.59 | $416.87 | $489.78 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $70.79 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $346.74 | $446.68 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Facility | None | $501.19 | $501.19 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $794.33 | Professional | None | $302.00 | $562.34 | $794.33 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $2,344.23 Typical High $4,786.30 | Facility | None | $288.40 | $2,344.23 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $2,630.27 | Professional | None | $245.47 | $501.19 | $2,630.27 |
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 $245.47 Median $398.11 Typical High $575.44 | Professional | None | $245.47 | $398.11 | $575.44 |
4 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 Professional Modifier 52 · Reduced service Typical Low $141.25 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $50.12 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $549.54 Median $707.95 Typical High $851.14 | Professional | 22 · Increased work | $549.54 | $707.95 | $851.14 |
Where North Dakota sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 9th of 51
$537
AK $1,202UT $219
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.