How much rates vary
Facilitymedian $417 · 10th to 90th $339 to $2,512Professionalmedian $724 · 10th to 90th $417 to $1,072
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 $338.84 Median $416.87 Typical High $416.87 | Facility | None | $338.84 | $416.87 | $416.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $275.42 Typical High $316.23 | Facility | 54 · Surgery only | $257.04 | $275.42 | $316.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $41.69 | Facility | 56 · Pre-op care only | $33.88 | $36.31 | $41.69 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $257.04 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $239.88 | $257.04 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $467.74 | Professional | None | $331.13 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $331.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,071.52 | Professional | None | $602.56 | $776.25 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $724.44 Median $933.25 Typical High $1,288.25 | Professional | 22 · Increased work | $724.44 | $933.25 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,174.90 Typical High $1,621.81 | Professional | 50 · Both sides | $891.25 | $1,174.90 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $549.54 Typical High $758.58 | Professional | 54 · Surgery only | $416.87 | $549.54 | $758.58 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $107.15 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $107.15 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $588.84 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $446.68 | $588.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $870.96 | Facility | None | $758.58 | $758.58 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $776.25 Typical High $1,202.26 | Professional | None | $380.19 | $776.25 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $2,454.71 | Facility | None | $338.84 | $602.56 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $2,570.40 | Professional | None | $426.58 | $741.31 | $2,570.40 |
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 $346.74 Median $630.96 Typical High $794.33 | Professional | None | $346.74 | $630.96 | $794.33 |
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 $169.82 Median $181.97 Typical High $208.93 | Facility | 52 · Reduced service | $169.82 | $181.97 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $83.18 | Facility | 53 · Discontinued | $67.61 | $74.13 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $63.10 | Facility | 55 · Aftercare only | $51.29 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $169.82 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $93.33 | Professional | 53 · Discontinued | $67.61 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $70.79 |
Where North Dakota sits
The same service costs 5.0 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· 7th of 51
$724
AK $1,380UT $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.