How much rates vary
Facilitymedian $1,995 · 10th to 90th $562 to $3,311Professionalmedian $1,096 · 10th to 90th $562 to $1,479
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 $562.34 Median $562.34 Typical High $6,456.54 | Facility | None | $562.34 | $562.34 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $851.14 | Professional | None | $512.86 | $562.34 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $478.63 |
BCBS North Dakota Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,456.54 | Facility | None | $5,495.41 | $5,495.41 | $6,456.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,479.11 | Professional | None | $977.24 | $1,258.93 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $676.08 | $891.25 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $147.91 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $724.44 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,479.11 | Professional | None | $602.56 | $1,047.13 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,995.26 Typical High $3,235.94 | Facility | None | $562.34 | $1,995.26 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $954.99 Typical High $4,168.69 | Professional | None | $467.74 | $954.99 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,122.02 | Professional | None | $467.74 | $776.25 | $1,122.02 |
5 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 $263.03 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $102.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,174.90 Median $1,513.56 Typical High $1,778.28 | Professional | 22 · Increased work | $1,174.90 | $1,513.56 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,905.46 Typical High $2,238.72 | Professional | 50 · Both sides | $1,479.11 | $1,905.46 | $2,238.72 |
Where North Dakota sits
The same service costs 4.0 times more in Oklahoma than in Montana. 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
OK $7,422MT $1,867
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.