How much rates vary
Facilitymedian $4,898 · 10th to 90th $479 to $6,761Professionalmedian $6,761 · 10th to 90th $661 to $14,454
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 $478.63 Median $1,819.70 Typical High $6,760.83 | Facility | None | $478.63 | $1,819.70 | $6,760.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $5,128.61 | Facility | 54 · Surgery only | $354.81 | $354.81 | $5,128.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $4,786.30 | Facility | 78 · Unplanned return to OR | $331.13 | $331.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $1,445.44 Typical High $8,128.31 | Professional | None | $478.63 | $1,445.44 | $8,128.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $5,128.61 | Professional | 54 · Surgery only | $354.81 | $446.68 | $5,128.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $416.87 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $331.13 | $416.87 | $4,786.30 |
BCBS North Dakota Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $13,803.84 | Professional | None | $851.14 | $1,258.93 | $13,803.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,023.29 Median $1,513.56 Typical High $16,595.87 | Professional | 22 · Increased work | $1,023.29 | $1,513.56 | $16,595.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $891.25 Typical High $9,772.37 | Professional | 54 · Surgery only | $588.84 | $891.25 | $9,772.37 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $954.99 Typical High $10,471.29 | Professional | 78 · Unplanned return to OR | $630.96 | $954.99 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $10,964.78 | Facility | None | $9,549.93 | $9,549.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $5,011.87 Typical High $15,135.61 | Professional | None | $676.08 | $5,011.87 | $15,135.61 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $4,897.79 Typical High $7,762.47 | Facility | None | $478.63 | $4,897.79 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $6,760.83 Median $13,489.63 Typical High $20,892.96 | Professional | None | $6,760.83 | $13,489.63 | $20,892.96 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,495.41 | Facility | None | $3,235.94 | $4,897.79 | $5,495.41 |
United Setting Professional Modifier None Typical Low $501.19 Median $5,754.40 Typical High $14,454.40 | Professional | None | $501.19 | $5,754.40 | $14,454.40 |
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 $234.42 Median $234.42 Typical High $3,388.44 | Facility | 52 · Reduced service | $234.42 | $234.42 | $3,388.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $1,348.96 | Facility | 53 · Discontinued | $95.50 | $95.50 | $1,348.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $1,023.29 | Facility | 55 · Aftercare only | $70.79 | $70.79 | $1,023.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $676.08 | Facility | 56 · Pre-op care only | $47.86 | $47.86 | $676.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $302.00 Typical High $3,388.44 | Professional | 52 · Reduced service | $234.42 | $302.00 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $1,348.96 | Professional | 53 · Discontinued | $95.50 | $120.23 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $89.13 Typical High $1,023.29 | Professional | 55 · Aftercare only | $70.79 | $89.13 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $676.08 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $676.08 |
Where North Dakota sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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
OK $20,151MS $3,466
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.