How much rates vary
Facilitymedian $288 · 10th to 90th $182 to $525Professionalmedian $603 · 10th to 90th $302 to $813
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 $288.40 Median $302.00 Typical High $302.00 | Facility | None | $288.40 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $223.87 | Facility | 54 · Surgery only | $218.78 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $30.20 | Facility | 56 · Pre-op care only | $28.84 | $30.20 | $30.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $208.93 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $316.23 | Professional | None | $251.19 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $234.42 | Professional | 54 · Surgery only | $218.78 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $208.93 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $204.17 | $208.93 | $218.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $831.76 | Professional | None | $537.03 | $676.08 | $831.76 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $645.65 Median $812.83 Typical High $1,000.00 | Professional | 22 · Increased work | $645.65 | $812.83 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $478.63 | $575.44 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $83.18 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $83.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $645.65 Typical High $933.25 | Professional | None | $309.03 | $645.65 | $933.25 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $288.40 Typical High $524.81 | Facility | None | $134.90 | $288.40 | $524.81 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $2,238.72 | Professional | None | $316.23 | $588.84 | $2,238.72 |
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 $302.00 Median $537.03 Typical High $645.65 | Professional | None | $302.00 | $537.03 | $645.65 |
6 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 $144.54 Median $151.36 Typical High $151.36 | Facility | 52 · Reduced service | $144.54 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $60.26 | Facility | 53 · Discontinued | $57.54 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $44.67 | Facility | 55 · Aftercare only | $43.65 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $144.54 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $46.77 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $46.77 |
Where North Dakota sits
The same service costs 5.5 times more in Alaska than in Texas. 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
$603
AK $1,230TX $224
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.