How much rates vary
Facilitymedian $166 · 10th to 90th $93 to $282Professionalmedian $240 · 10th to 90th $158 to $490
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 $93.33 Median $165.96 Typical High $165.96 | Facility | None | $93.33 | $165.96 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $125.89 | Facility | 54 · Surgery only | $69.18 | $69.18 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $165.96 | Professional | None | $91.20 | $134.90 | $165.96 |
BCBS North Dakota Setting Facility Modifier None Typical Low $234.42 Median $269.15 Typical High $288.40 | Facility | None | $234.42 | $269.15 | $288.40 |
BCBS North Dakota Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $501.19 | Professional | None | $177.83 | $269.15 | $501.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $213.80 Median $323.59 Typical High $602.56 | Professional | 22 · Increased work | $213.80 | $323.59 | $602.56 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $346.74 | Professional | 54 · Surgery only | $125.89 | $186.21 | $346.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $199.53 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $134.90 | $199.53 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Facility | None | $295.12 | $295.12 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $457.09 | Professional | None | $144.54 | $269.15 | $457.09 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $281.84 | Facility | None | $93.33 | $165.96 | $281.84 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $870.96 | Professional | None | $173.78 | $302.00 | $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 $100.00 Median $186.21 Typical High $316.23 | Professional | None | $100.00 | $186.21 | $316.23 |
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 $46.77 Median $46.77 Typical High $83.18 | Facility | 52 · Reduced service | $46.77 | $46.77 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $33.88 | Facility | 53 · Discontinued | $18.62 | $18.62 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $25.12 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $16.60 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $16.60 |
Where North Dakota sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $3,027MD $261
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.