How much rates vary
Facilitymedian $151 · 10th to 90th $117 to $269Professionalmedian $245 · 10th to 90th $141 to $347
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 $117.49 Median $151.36 Typical High $151.36 | Facility | None | $117.49 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $112.20 | Facility | 54 · Surgery only | $89.13 | $95.50 | $112.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $89.13 Typical High $104.71 | Facility | 78 · Unplanned return to OR | $83.18 | $89.13 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $162.18 | Professional | None | $114.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $117.49 | Professional | 54 · Surgery only | $89.13 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $89.13 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $83.18 | $89.13 | $109.65 |
BCBS North Dakota Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $346.74 | Professional | None | $204.17 | $257.04 | $346.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $309.03 Typical High $416.87 | Professional | 22 · Increased work | $245.47 | $309.03 | $416.87 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $380.19 Typical High $524.81 | Professional | 50 · Both sides | $309.03 | $380.19 | $524.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $144.54 | $177.83 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $190.55 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $190.55 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $288.40 | Facility | None | $251.19 | $251.19 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $398.11 | Professional | None | $125.89 | $263.03 | $398.11 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $269.15 | Facility | None | $117.49 | $151.36 | $269.15 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $870.96 | Professional | None | $151.36 | $275.42 | $870.96 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $295.12 | Professional | None | $120.23 | $223.87 | $295.12 |
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 $58.88 Median $63.10 Typical High $74.13 | Facility | 52 · Reduced service | $58.88 | $63.10 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $30.20 | Facility | 53 · Discontinued | $23.44 | $25.12 | $30.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $22.39 | Facility | 55 · Aftercare only | $17.78 | $19.05 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $15.14 | Facility | 56 · Pre-op care only | $11.75 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $15.49 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska than in Florida. 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· 6th of 51
$245
AK $468FL $115
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.