How much rates vary
Facilitymedian $479 · 10th to 90th $309 to $2,570Professionalmedian $708 · 10th to 90th $437 to $1,148
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 $309.03 Median $478.63 Typical High $478.63 | Facility | None | $309.03 | $478.63 | $478.63 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $354.81 | Facility | 54 · Surgery only | $234.42 | $251.19 | $354.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $47.86 | Facility | 56 · Pre-op care only | $30.90 | $33.88 | $47.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $234.42 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $218.78 | $234.42 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $512.86 | Professional | None | $309.03 | $338.84 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $257.04 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $239.88 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $239.88 | $354.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,148.15 | Professional | None | $549.54 | $794.33 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $660.69 Median $954.99 Typical High $1,380.38 | Professional | 22 · Increased work | $660.69 | $954.99 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,174.90 Typical High $1,737.80 | Professional | 50 · Both sides | $831.76 | $1,174.90 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $549.54 Typical High $812.83 | Professional | 54 · Surgery only | $389.05 | $549.54 | $812.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $79.43 Typical High $114.82 | Professional | 56 · Pre-op care only | $54.95 | $79.43 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Facility | None | $831.76 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $1,318.26 | Professional | None | $416.87 | $794.33 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $676.08 Typical High $2,511.89 | Facility | None | $309.03 | $676.08 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $2,344.23 | Professional | None | $478.63 | $870.96 | $2,344.23 |
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 $316.23 Median $588.84 Typical High $933.25 | Professional | None | $316.23 | $588.84 | $933.25 |
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 $154.88 Median $169.82 Typical High $239.88 | Facility | 52 · Reduced service | $154.88 | $169.82 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $95.50 | Facility | 53 · Discontinued | $61.66 | $67.61 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $72.44 | Facility | 55 · Aftercare only | $46.77 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $169.82 Typical High $257.04 | Professional | 52 · Reduced service | $154.88 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $102.33 | Professional | 53 · Discontinued | $61.66 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $75.86 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $75.86 |
Where North Dakota sits
The same service costs 5.9 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
$692
AK $1,698UT $288
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.