How much rates vary
Facilitymedian $145 · 10th to 90th $117 to $676Professionalmedian $257 · 10th to 90th $135 to $372
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 $117.49 Median $144.54 Typical High $1,995.26 | Facility | None | $117.49 | $144.54 | $1,995.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $109.65 | Facility | 54 · Surgery only | $87.10 | $87.10 | $109.65 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $102.33 | Facility | 78 · Unplanned return to OR | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $208.93 | Professional | None | $112.20 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $109.65 | Professional | 54 · Surgery only | $87.10 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $93.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $81.28 | $93.33 | $102.33 |
BCBS North Dakota Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
BCBS North Dakota Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | None | $218.78 | $288.40 | $380.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $263.03 Median $346.74 Typical High $457.09 | Professional | 22 · Increased work | $263.03 | $346.74 | $457.09 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $199.53 Typical High $269.15 | Professional | 54 · Surgery only | $151.36 | $199.53 | $269.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $281.84 | Facility | None | $245.47 | $245.47 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $389.05 | Professional | None | $144.54 | $263.03 | $389.05 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $269.15 | Facility | None | $117.49 | $144.54 | $269.15 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $870.96 | Professional | None | $154.88 | $275.42 | $870.96 |
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 $229.09 Typical High $295.12 | Professional | None | $128.82 | $229.09 | $295.12 |
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 $58.88 Median $58.88 Typical High $72.44 | Facility | 52 · Reduced service | $58.88 | $58.88 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $28.84 | Facility | 53 · Discontinued | $23.44 | $23.44 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $21.88 | Facility | 55 · Aftercare only | $17.78 | $17.78 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $14.45 | Facility | 56 · Pre-op care only | $11.75 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $66.07 Typical High $72.44 | Professional | 52 · Reduced service | $58.88 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $23.44 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $14.45 |
Where North Dakota sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 7th of 51
$251
AK $501FL $129
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.