How much rates vary
Facilitymedian $575 · 10th to 90th $229 to $2,754Professionalmedian $525 · 10th to 90th $331 to $813
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 $229.09 Median $363.08 Typical High $3,801.89 | Facility | None | $229.09 | $363.08 | $3,801.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $275.42 | Facility | 54 · Surgery only | $173.78 | $173.78 | $275.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $36.31 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $162.18 | $162.18 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $575.44 | Professional | None | $229.09 | $354.81 | $575.44 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $2,818.38 | Facility | None | $1,513.56 | $2,454.71 | $2,818.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $851.14 | Professional | None | $436.52 | $588.84 | $851.14 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $524.81 Median $707.95 Typical High $1,023.29 | Professional | 22 · Increased work | $524.81 | $707.95 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $416.87 Typical High $588.84 | Professional | 54 · Surgery only | $302.00 | $416.87 | $588.84 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $58.88 Typical High $85.11 | Professional | 56 · Pre-op care only | $43.65 | $58.88 | $85.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $446.68 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $323.59 | $446.68 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Facility | None | $575.44 | $575.44 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $891.25 | Professional | None | $380.19 | $575.44 | $891.25 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $645.65 Typical High $2,754.23 | Facility | None | $229.09 | $645.65 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $794.33 | Professional | None | $371.54 | $707.95 | $794.33 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $776.25 | Professional | None | $234.42 | $436.52 | $776.25 |
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 Facility Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $181.97 | Facility | 52 · Reduced service | $114.82 | $114.82 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $72.44 | Facility | 53 · Discontinued | $45.71 | $45.71 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $54.95 | Facility | 55 · Aftercare only | $34.67 | $34.67 | $54.95 |
Where North Dakota sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 13th of 51
$525
AK $1,259UT $275
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.