How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $5,754Professionalmedian $6,607 · 10th to 90th $3,467 to $8,913
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $4,265.80 | Professional | None | $3,235.94 | $3,467.37 | $4,265.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,630.27 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,398.83 | $2,630.27 | $3,162.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $346.74 Typical High $426.58 | Professional | 56 · Pre-op care only | $323.59 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,454.71 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,454.71 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier None Typical Low $5,888.44 Median $7,585.78 Typical High $8,912.51 | Professional | None | $5,888.44 | $7,585.78 | $8,912.51 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $5,370.32 Typical High $6,309.57 | Professional | 54 · Surgery only | $4,073.80 | $5,370.32 | $6,309.57 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $758.58 Typical High $891.25 | Professional | 56 · Pre-op care only | $588.84 | $758.58 | $891.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,365.16 Median $5,754.40 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $4,365.16 | $5,754.40 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,606.93 | Facility | None | $5,754.40 | $5,754.40 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $7,244.36 Typical High $9,772.37 | Professional | None | $5,495.41 | $7,244.36 | $9,772.37 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $5,888.44 | Facility | None | $758.58 | $2,344.23 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $2,818.38 Median $5,888.44 Typical High $25,703.96 | Professional | None | $2,818.38 | $5,888.44 | $25,703.96 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Facility | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $4,677.35 Typical High $6,760.83 | Professional | None | $2,818.38 | $4,677.35 | $6,760.83 |
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 $1,584.89 Median $1,737.80 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,584.89 | $1,737.80 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $691.83 Typical High $851.14 | Professional | 53 · Discontinued | $645.65 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $524.81 Typical High $645.65 | Professional | 55 · Aftercare only | $478.63 | $524.81 | $645.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $7,079.46 Median $9,120.11 Typical High $10,715.19 | Professional | 22 · Increased work | $7,079.46 | $9,120.11 | $10,715.19 |
Where North Dakota sits
The same service costs 27.5 times more in Alaska 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· 9th of 51
$6,607
AK $14,454TX $525
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.