How much rates vary
Facilitymedian $525 · 10th to 90th $468 to $871Professionalmedian $1,000 · 10th to 90th $525 to $1,288
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 $501.19 Median $524.81 Typical High $524.81 | Facility | None | $501.19 | $524.81 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $389.05 | Facility | 54 · Surgery only | $371.54 | $389.05 | $389.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $52.48 | Facility | 56 · Pre-op care only | $50.12 | $52.48 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $602.56 | Professional | None | $501.19 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $380.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,258.93 | Professional | None | $831.76 | $1,023.29 | $1,258.93 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,000.00 Median $1,230.27 Typical High $1,513.56 | Professional | 22 · Increased work | $1,000.00 | $1,230.27 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,548.82 Typical High $1,905.46 | Professional | 50 · Both sides | $1,230.27 | $1,548.82 | $1,905.46 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $575.44 | $724.44 | $870.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $125.89 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Facility | None | $891.25 | $891.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,071.52 Typical High $1,412.54 | Professional | None | $489.78 | $1,071.52 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $891.25 | Facility | None | $446.68 | $562.34 | $891.25 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $3,715.35 | Professional | None | $524.81 | $977.24 | $3,715.35 |
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 $512.86 Median $912.01 Typical High $1,047.13 | Professional | None | $512.86 | $912.01 | $1,047.13 |
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 $251.19 Median $257.04 Typical High $257.04 | Facility | 52 · Reduced service | $251.19 | $257.04 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $104.71 | Facility | 53 · Discontinued | $100.00 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $77.62 | Facility | 55 · Aftercare only | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $100.00 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $83.18 |
Where North Dakota sits
The same service costs 6.2 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
$933
AK $1,995UT $324
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.