How much rates vary
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 $83.18 Median $234.42 Typical High $288.40 | Facility | None | $83.18 | $234.42 | $288.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $213.80 | Facility | 54 · Surgery only | $61.66 | $61.66 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $288.40 | Professional | None | $67.61 | $83.18 | $288.40 |
BCBS Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $575.44 | Professional | None | $131.83 | $194.98 | $575.44 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $158.49 Median $234.42 Typical High $691.83 | Professional | 22 · Increased work | $158.49 | $234.42 | $691.83 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $138.04 Typical High $398.11 | Professional | 54 · Surgery only | $91.20 | $138.04 | $398.11 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $147.91 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $97.72 | $147.91 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Facility | None | $416.87 | $416.87 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $645.65 | Professional | None | $102.33 | $229.09 | $645.65 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $251.19 Typical High $489.78 | Facility | None | $83.18 | $251.19 | $489.78 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $616.60 | Professional | None | $288.40 | $524.81 | $616.60 |
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 $85.11 Median $223.87 Typical High $562.34 | Professional | None | $85.11 | $223.87 | $562.34 |
4 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 $41.69 Median $41.69 Typical High $144.54 | Facility | 52 · Reduced service | $41.69 | $41.69 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $57.54 | Facility | 53 · Discontinued | $16.60 | $16.60 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $42.66 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $28.84 | Facility | 56 · Pre-op care only | $8.32 | $8.32 | $28.84 |
Where North Dakota sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 16th of 51
$263
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.