How much rates vary
Facilitymedian $316 · 10th to 90th $234 to $759Professionalmedian $490 · 10th to 90th $302 to $708
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 $234.42 Median $302.00 Typical High $316.23 | Facility | None | $234.42 | $302.00 | $316.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $229.09 | Facility | 54 · Surgery only | $177.83 | $186.21 | $229.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $30.20 | Facility | 56 · Pre-op care only | $23.44 | $25.12 | $30.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $165.96 | $173.78 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $316.23 | Professional | None | $234.42 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $177.83 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $165.96 | $181.97 | $223.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $724.44 | Professional | None | $407.38 | $524.81 | $724.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $478.63 Median $630.96 Typical High $870.96 | Professional | 22 · Increased work | $478.63 | $630.96 | $870.96 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $794.33 Typical High $1,096.48 | Professional | 50 · Both sides | $602.56 | $794.33 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $281.84 | $371.54 | $512.86 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $40.74 | $52.48 | $72.44 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $398.11 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $302.00 | $398.11 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Facility | None | $512.86 | $512.86 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $549.54 Typical High $812.83 | Professional | None | $257.04 | $549.54 | $812.83 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $416.87 Typical High $758.58 | Facility | None | $234.42 | $416.87 | $758.58 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $707.95 | Professional | None | $309.03 | $549.54 | $707.95 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $588.84 | Professional | None | $239.88 | $446.68 | $588.84 |
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 $117.49 Median $125.89 Typical High $151.36 | Facility | 52 · Reduced service | $117.49 | $125.89 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $60.26 | Facility | 53 · Discontinued | $47.86 | $50.12 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $38.02 Typical High $45.71 | Facility | 55 · Aftercare only | $35.48 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $47.86 |
Where North Dakota sits
The same service costs 4.2 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· 8th of 51
$479
AK $955UT $229
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.