How much rates vary
Facilitymedian $468 · 10th to 90th $295 to $2,512Professionalmedian $692 · 10th to 90th $447 to $1,096
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 $295.12 Median $467.74 Typical High $467.74 | Facility | None | $295.12 | $467.74 | $467.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $346.74 | Facility | 54 · Surgery only | $218.78 | $239.88 | $346.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $46.77 | Facility | 56 · Pre-op care only | $29.51 | $31.62 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $204.17 | $223.87 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $489.78 | Professional | None | $295.12 | $323.59 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $245.47 Typical High $363.08 | Professional | 54 · Surgery only | $218.78 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $48.98 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $338.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,096.48 | Professional | None | $524.81 | $741.31 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $630.96 Median $891.25 Typical High $1,318.26 | Professional | 22 · Increased work | $630.96 | $891.25 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,122.02 Typical High $1,659.59 | Professional | 50 · Both sides | $776.25 | $1,122.02 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $363.08 | $524.81 | $776.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $74.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $52.48 | $74.13 | $109.65 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $389.05 | $562.34 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Facility | None | $794.33 | $794.33 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $1,258.93 | Professional | None | $398.11 | $758.58 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $2,454.71 | Facility | None | $295.12 | $512.86 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $2,187.76 | Professional | None | $467.74 | $851.14 | $2,187.76 |
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 $295.12 Median $562.34 Typical High $912.01 | Professional | None | $295.12 | $562.34 | $912.01 |
6 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 $147.91 Median $158.49 Typical High $229.09 | Facility | 52 · Reduced service | $147.91 | $158.49 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $93.33 | Facility | 53 · Discontinued | $58.88 | $63.10 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $69.18 | Facility | 55 · Aftercare only | $43.65 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $162.18 Typical High $245.47 | Professional | 52 · Reduced service | $147.91 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $97.72 | Professional | 53 · Discontinued | $58.88 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $48.98 Typical High $72.44 | Professional | 55 · Aftercare only | $43.65 | $48.98 | $72.44 |
Where North Dakota sits
The same service costs 5.5 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· 10th of 51
$661
AK $1,585UT $288
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.