How much rates vary
Facilitymedian $832 · 10th to 90th $676 to $2,570Professionalmedian $1,514 · 10th to 90th $813 to $2,089
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 $676.08 Median $812.83 Typical High $831.76 | Facility | None | $676.08 | $812.83 | $831.76 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $616.60 | Facility | 54 · Surgery only | $501.19 | $501.19 | $616.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $83.18 | Facility | 56 · Pre-op care only | $67.61 | $67.61 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $467.74 | $467.74 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $851.14 | Professional | None | $602.56 | $724.44 | $851.14 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,584.89 | $2,187.76 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,479.11 Median $1,905.46 Typical High $2,630.27 | Professional | 22 · Increased work | $1,479.11 | $1,905.46 | $2,630.27 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,398.83 Typical High $3,235.94 | Professional | 50 · Both sides | $1,862.09 | $2,398.83 | $3,235.94 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $1,513.56 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $158.49 Typical High $218.78 | Professional | 56 · Pre-op care only | $123.03 | $158.49 | $218.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,174.90 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $912.01 | $1,174.90 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,659.59 | Facility | None | $1,445.44 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,570.40 | Professional | None | $977.24 | $1,584.89 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $2,511.89 | Facility | None | $676.08 | $1,202.26 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,513.56 Typical High $1,778.28 | Professional | None | $851.14 | $1,513.56 | $1,778.28 |
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 $707.95 Median $1,258.93 Typical High $1,621.81 | Professional | None | $707.95 | $1,258.93 | $1,621.81 |
3 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 $338.84 Median $338.84 Typical High $416.87 | Facility | 52 · Reduced service | $338.84 | $338.84 | $416.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $165.96 | Facility | 53 · Discontinued | $134.90 | $134.90 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $125.89 | Facility | 55 · Aftercare only | $100.00 | $100.00 | $125.89 |
Where North Dakota sits
The same service costs 3.7 times more in Connecticut than in Arkansas. 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
CT $7,673AR $2,094
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.