How much rates vary
Facilitymedian $372 · 10th to 90th $240 to $2,512Professionalmedian $525 · 10th to 90th $339 to $891
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 $239.88 Median $371.54 Typical High $371.54 | Facility | None | $239.88 | $371.54 | $371.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $281.84 | Facility | 54 · Surgery only | $177.83 | $186.21 | $281.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $165.96 | $173.78 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $398.11 | Professional | None | $239.88 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $181.97 | $275.42 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $912.01 | Professional | None | $389.05 | $588.84 | $912.01 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $707.95 Typical High $1,096.48 | Professional | 22 · Increased work | $467.74 | $707.95 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $891.25 Typical High $1,348.96 | Professional | 50 · Both sides | $588.84 | $891.25 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $416.87 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $416.87 | $630.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $446.68 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $295.12 | $446.68 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $741.31 | Facility | None | $645.65 | $645.65 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $616.60 Typical High $1,000.00 | Professional | None | $323.59 | $616.60 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $2,454.71 | Facility | None | $239.88 | $416.87 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $1,737.80 | Professional | None | $380.19 | $691.83 | $1,737.80 |
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 $245.47 Median $457.09 Typical High $724.44 | Professional | None | $245.47 | $457.09 | $724.44 |
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 $120.23 Median $123.03 Typical High $186.21 | Facility | 52 · Reduced service | $120.23 | $123.03 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $74.13 | Facility | 53 · Discontinued | $47.86 | $50.12 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $56.23 | Facility | 55 · Aftercare only | $36.31 | $37.15 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $37.15 | Facility | 56 · Pre-op care only | $23.99 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $131.83 Typical High $199.53 | Professional | 52 · Reduced service | $120.23 | $131.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $52.48 Typical High $79.43 | Professional | 53 · Discontinued | $47.86 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.30 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.99 | $26.30 | $39.81 |
Where North Dakota sits
The same service costs 3.9 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· 11th of 51
$513
WY $1,096UT $282
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.