How much rates vary
Facilitymedian $316 · 10th to 90th $275 to $759Professionalmedian $562 · 10th to 90th $302 to $724
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 $275.42 Median $295.12 Typical High $295.12 | Facility | None | $275.42 | $295.12 | $295.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $223.87 | Facility | 54 · Surgery only | $208.93 | $218.78 | $223.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $29.51 | Facility | 56 · Pre-op care only | $27.54 | $29.51 | $29.51 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $204.17 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $194.98 | $204.17 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $602.56 | Professional | None | $275.42 | $295.12 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $208.93 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $223.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $724.44 | Professional | None | $457.09 | $575.44 | $724.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $549.54 Median $691.83 Typical High $870.96 | Professional | 22 · Increased work | $549.54 | $691.83 | $870.96 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $870.96 Typical High $1,096.48 | Professional | 50 · Both sides | $691.83 | $870.96 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $323.59 | $407.38 | $512.86 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $45.71 | $57.54 | $72.44 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $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 $407.38 Median $602.56 Typical High $812.83 | Professional | None | $407.38 | $602.56 | $812.83 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $776.25 | Facility | None | $275.42 | $467.74 | $776.25 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $3,235.94 | Professional | None | $302.00 | $562.34 | $3,235.94 |
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 $281.84 Median $512.86 Typical High $588.84 | Professional | None | $281.84 | $512.86 | $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 $138.04 Median $147.91 Typical High $147.91 | Facility | 52 · Reduced service | $138.04 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $60.26 | Facility | 53 · Discontinued | $54.95 | $58.88 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $44.67 | Facility | 55 · Aftercare only | $41.69 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $47.86 |
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· 17th of 51
$550
AK $1,096UT $219
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.