How much rates vary
Facilitymedian $240 · 10th to 90th $132 to $407Professionalmedian $316 · 10th to 90th $162 to $631
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 $134.90 Median $239.88 Typical High $239.88 | Facility | None | $134.90 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $177.83 | Facility | 54 · Surgery only | $102.33 | $102.33 | $177.83 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $95.50 | $95.50 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $489.78 | Professional | None | $131.83 | $223.87 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $177.83 Typical High $186.21 | Professional | 54 · Surgery only | $102.33 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $165.96 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $95.50 | $165.96 | $173.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $630.96 | Professional | None | $263.03 | $398.11 | $630.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $316.23 Median $478.63 Typical High $758.58 | Professional | 22 · Increased work | $316.23 | $478.63 | $758.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $281.84 Typical High $436.52 | Professional | 54 · Surgery only | $186.21 | $281.84 | $436.52 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $302.00 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $199.53 | $302.00 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Facility | None | $426.58 | $426.58 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $616.60 | Professional | None | $181.97 | $354.81 | $616.60 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $407.38 | Facility | None | $125.89 | $239.88 | $407.38 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $436.52 Typical High $1,778.28 | Professional | None | $199.53 | $436.52 | $1,778.28 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $467.74 | Professional | None | $128.82 | $251.19 | $467.74 |
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 $67.61 Median $67.61 Typical High $120.23 | Facility | 52 · Reduced service | $67.61 | $67.61 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $47.86 | Facility | 53 · Discontinued | $27.54 | $27.54 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $36.31 | Facility | 55 · Aftercare only | $20.42 | $20.42 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $23.99 | Facility | 56 · Pre-op care only | $13.80 | $13.80 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $117.49 Typical High $123.03 | Professional | 52 · Reduced service | $67.61 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $46.77 Typical High $50.12 | Professional | 53 · Discontinued | $27.54 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $35.48 Typical High $37.15 | Professional | 55 · Aftercare only | $20.42 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $23.44 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.80 | $23.44 | $24.55 |
Where North Dakota sits
The same service costs 3.5 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· 12th of 51
$309
AK $562DC $162
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.