How much rates vary
Facilitymedian $537 · 10th to 90th $468 to $933Professionalmedian $1,000 · 10th to 90th $550 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 $537.03 Typical High $537.03 | Facility | None | $501.19 | $537.03 | $537.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $398.11 | Facility | 54 · Surgery only | $371.54 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $53.70 | Facility | 56 · Pre-op care only | $50.12 | $52.48 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $371.54 | Facility | 78 · Unplanned return to OR | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $831.76 | Professional | None | $501.19 | $537.03 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $398.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,288.25 | Professional | None | $831.76 | $1,047.13 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,000.00 Median $1,258.93 Typical High $1,548.82 | Professional | 22 · Increased work | $1,000.00 | $1,258.93 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $1,949.84 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $912.01 | Professional | 54 · Surgery only | $588.84 | $724.44 | $912.01 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $83.18 | $104.71 | $128.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Facility | None | $912.01 | $912.01 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,071.52 Typical High $1,445.44 | Professional | None | $489.78 | $1,071.52 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $933.25 | Facility | None | $446.68 | $562.34 | $933.25 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $3,890.45 | Professional | None | $549.54 | $1,000.00 | $3,890.45 |
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 $1,071.52 | Professional | None | $512.86 | $912.01 | $1,071.52 |
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 $263.03 Typical High $269.15 | Facility | 52 · Reduced service | $251.19 | $263.03 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $107.15 | Facility | 53 · Discontinued | $100.00 | $107.15 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $79.43 | Facility | 55 · Aftercare only | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $85.11 |
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· 10th of 51
$955
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.