How much rates vary
Facilitymedian $2,512 · 10th to 90th $759 to $4,074Professionalmedian $5,623 · 10th to 90th $2,951 to $7,413
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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,951.21 | $3,630.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $295.12 Typical High $363.08 | Professional | 56 · Pre-op care only | $269.15 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,089.30 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,089.30 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $4,897.79 Median $6,309.57 Typical High $7,413.10 | Professional | None | $4,897.79 | $6,309.57 | $7,413.10 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $5,888.44 Median $7,585.78 Typical High $8,912.51 | Professional | 22 · Increased work | $5,888.44 | $7,585.78 | $8,912.51 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $4,466.84 Typical High $5,248.07 | Professional | 54 · Surgery only | $3,467.37 | $4,466.84 | $5,248.07 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $630.96 Typical High $741.31 | Professional | 56 · Pre-op care only | $489.78 | $630.96 | $741.31 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,715.35 Median $4,786.30 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $3,715.35 | $4,786.30 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,495.41 | Facility | None | $4,786.30 | $4,786.30 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $5,370.32 Typical High $7,585.78 | Professional | None | $3,019.95 | $5,370.32 | $7,585.78 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $5,011.87 | Facility | None | $758.58 | $2,344.23 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $5,011.87 Typical High $21,877.62 | Professional | None | $2,344.23 | $5,011.87 | $21,877.62 |
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 $2,238.72 Median $4,073.80 Typical High $5,888.44 | Professional | None | $2,238.72 | $4,073.80 | $5,888.44 |
3 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 $1,348.96 Median $1,479.11 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $588.84 Typical High $724.44 | Professional | 53 · Discontinued | $537.03 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $537.03 |
Where North Dakota sits
The same service costs 6.0 times more in Alaska than in Maryland. 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.
Physician feeFacility fee
AK $22,256MD $3,725
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.