How much rates vary
Facilitymedian $275 · 10th to 90th $195 to $759Professionalmedian $457 · 10th to 90th $204 to $759
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 $194.98 Median $275.42 Typical High $645.65 | Facility | None | $194.98 | $275.42 | $645.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $208.93 | Facility | 54 · Surgery only | $144.54 | $144.54 | $208.93 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $134.90 | $134.90 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $562.34 | Professional | None | $190.55 | $269.15 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $194.98 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $194.98 | $208.93 |
BCBS North Dakota Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,380.38 | Facility | None | $630.96 | $630.96 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $758.58 | Professional | None | $389.05 | $537.03 | $758.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $630.96 Typical High $912.01 | Professional | 22 · Increased work | $467.74 | $630.96 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $371.54 Typical High $537.03 | Professional | 54 · Surgery only | $275.42 | $371.54 | $537.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $398.11 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $295.12 | $398.11 | $575.44 |
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 $229.09 Median $457.09 Typical High $724.44 | Professional | None | $229.09 | $457.09 | $724.44 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $398.11 Typical High $758.58 | Facility | None | $194.98 | $398.11 | $758.58 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $478.63 Typical High $2,089.30 | Professional | None | $234.42 | $478.63 | $2,089.30 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $537.03 | Professional | None | $165.96 | $323.59 | $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 $97.72 Median $97.72 Typical High $138.04 | Facility | 52 · Reduced service | $97.72 | $97.72 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $54.95 | Facility | 53 · Discontinued | $38.90 | $38.90 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $41.69 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $27.54 | Facility | 56 · Pre-op care only | $19.50 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $97.72 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $28.84 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $30.20 |
Where North Dakota sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 8th of 51
$447
AK $776KY $204
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.