How much rates vary
Facilitymedian $263 · 10th to 90th $155 to $1,202Professionalmedian $347 · 10th to 90th $224 to $661
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 $154.88 Median $263.03 Typical High $269.15 | Facility | None | $154.88 | $263.03 | $269.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $199.53 | Facility | 54 · Surgery only | $117.49 | $117.49 | $199.53 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $275.42 | Professional | None | $147.91 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $117.49 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $190.55 |
BCBS North Dakota Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $660.69 | Professional | None | $288.40 | $416.87 | $660.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $346.74 Median $501.19 Typical High $794.33 | Professional | 22 · Increased work | $346.74 | $501.19 | $794.33 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $288.40 Typical High $467.74 | Professional | 54 · Surgery only | $199.53 | $288.40 | $467.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $309.03 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $309.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $537.03 | Facility | None | $457.09 | $457.09 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $398.11 Typical High $724.44 | Professional | None | $190.55 | $398.11 | $724.44 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $1,096.48 | Facility | None | $154.88 | $275.42 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $1,174.90 | Professional | None | $269.15 | $489.78 | $1,174.90 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $524.81 | Professional | None | $162.18 | $309.03 | $524.81 |
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 $77.62 Median $77.62 Typical High $131.83 | Facility | 52 · Reduced service | $77.62 | $77.62 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $53.70 | Facility | 53 · Discontinued | $30.90 | $30.90 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $39.81 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $26.30 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $77.62 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $53.70 | Professional | 53 · Discontinued | $30.90 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $26.92 |
Where North Dakota sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 12th of 51
$347
AK $759KY $170
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.