How much rates vary
Facilitymedian $407 · 10th to 90th $162 to $1,230Professionalmedian $417 · 10th to 90th $214 to $1,096
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 $162.18 Median $407.38 Typical High $407.38 | Facility | None | $162.18 | $407.38 | $407.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $302.00 | Facility | 54 · Surgery only | $120.23 | $120.23 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $446.68 | Professional | None | $162.18 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $120.23 | $295.12 | $338.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $1,096.48 | Professional | None | $281.84 | $446.68 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $338.84 Median $537.03 Typical High $1,318.26 | Professional | 22 · Increased work | $338.84 | $537.03 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $316.23 Typical High $776.25 | Professional | 54 · Surgery only | $199.53 | $316.23 | $776.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Facility | None | $724.44 | $724.44 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $1,047.13 | Professional | None | $199.53 | $446.68 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $489.78 Typical High $1,230.27 | Facility | None | $162.18 | $489.78 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $707.95 Typical High $3,090.30 | Professional | None | $338.84 | $707.95 | $3,090.30 |
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 $162.18 Median $338.84 Typical High $758.58 | Professional | None | $162.18 | $338.84 | $758.58 |
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 $81.28 Median $81.28 Typical High $204.17 | Facility | 52 · Reduced service | $81.28 | $81.28 | $204.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $81.28 | Facility | 53 · Discontinued | $32.36 | $32.36 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $61.66 | Facility | 55 · Aftercare only | $23.99 | $23.99 | $61.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $40.74 | Facility | 56 · Pre-op care only | $16.22 | $16.22 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $81.28 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $32.36 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $23.99 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.22 | $38.90 | $44.67 |
Where North Dakota sits
The same service costs 4.5 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· 17th of 51
$417
AK $851DC $191
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.