How much rates vary
Facilitymedian $309 · 10th to 90th $200 to $2,570Professionalmedian $468 · 10th to 90th $302 to $759
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 $199.53 Median $309.03 Typical High $309.03 | Facility | None | $199.53 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $147.91 Median $162.18 Typical High $234.42 | Facility | 54 · Surgery only | $147.91 | $162.18 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $30.90 | Facility | 56 · Pre-op care only | $19.95 | $21.38 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $151.36 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $138.04 | $151.36 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $338.84 | Professional | None | $199.53 | $218.78 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $165.96 Typical High $251.19 | Professional | 54 · Surgery only | $147.91 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.95 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $234.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $776.25 | Professional | None | $354.81 | $501.19 | $776.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $426.58 Median $602.56 Typical High $912.01 | Professional | 22 · Increased work | $426.58 | $602.56 | $912.01 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $758.58 Typical High $1,148.15 | Professional | 50 · Both sides | $537.03 | $758.58 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $251.19 | $354.81 | $537.03 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $50.12 Typical High $77.62 | Professional | 56 · Pre-op care only | $35.48 | $50.12 | $77.62 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $269.15 | $380.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Facility | None | $549.54 | $549.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $524.81 Typical High $851.14 | Professional | None | $275.42 | $524.81 | $851.14 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $2,454.71 | Facility | None | $199.53 | $346.74 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $1,479.11 | Professional | None | $309.03 | $549.54 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $199.53 Median $380.19 Typical High $588.84 | Professional | None | $199.53 | $380.19 | $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 $100.00 Median $107.15 Typical High $154.88 | Facility | 52 · Reduced service | $100.00 | $107.15 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $61.66 | Facility | 53 · Discontinued | $39.81 | $42.66 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $29.51 Median $32.36 Typical High $46.77 | Facility | 55 · Aftercare only | $29.51 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $109.65 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $43.65 Typical High $67.61 | Professional | 53 · Discontinued | $39.81 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $50.12 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $50.12 |
Where North Dakota sits
The same service costs 4.3 times more in Wyoming 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· 9th of 51
$447
WY $933UT $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.