How much rates vary
Facilitymedian $282 · 10th to 90th $158 to $1,202Professionalmedian $355 · 10th to 90th $229 to $676
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 $158.49 Median $281.84 Typical High $295.12 | Facility | None | $158.49 | $281.84 | $295.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $125.89 Typical High $213.80 | Facility | 54 · Surgery only | $117.49 | $125.89 | $213.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $117.49 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $109.65 | $117.49 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $295.12 | Professional | None | $151.36 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $131.83 Typical High $223.87 | Professional | 54 · Surgery only | $117.49 | $131.83 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $123.03 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $109.65 | $123.03 | $208.93 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $676.08 | Professional | None | $269.15 | $407.38 | $676.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $323.59 Median $489.78 Typical High $812.83 | Professional | 22 · Increased work | $323.59 | $489.78 | $812.83 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $602.56 Typical High $1,023.29 | Professional | 50 · Both sides | $398.11 | $602.56 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $281.84 Typical High $467.74 | Professional | 54 · Surgery only | $186.21 | $281.84 | $467.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $302.00 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $199.53 | $302.00 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $758.58 | Professional | None | $234.42 | $426.58 | $758.58 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $389.05 Typical High $1,096.48 | Facility | None | $158.49 | $389.05 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,174.90 | Professional | None | $288.40 | $512.86 | $1,174.90 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $549.54 | Professional | None | $162.18 | $316.23 | $549.54 |
8 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 $79.43 Median $83.18 Typical High $141.25 | Facility | 52 · Reduced service | $79.43 | $83.18 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $56.23 | Facility | 53 · Discontinued | $31.62 | $33.11 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $25.12 Typical High $42.66 | Facility | 55 · Aftercare only | $23.44 | $25.12 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $28.18 | Facility | 56 · Pre-op care only | $15.85 | $16.60 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $87.10 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $58.88 | Professional | 53 · Discontinued | $31.62 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $44.67 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $29.51 |
Where North Dakota sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 13th of 51
$347
WY $741KY $195
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.