How much rates vary
Facilitymedian $501 · 10th to 90th $324 to $1,698Professionalmedian $776 · 10th to 90th $347 to $1,318
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 $323.59 Median $501.19 Typical High $512.86 | Facility | None | $323.59 | $501.19 | $512.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $380.19 | Facility | 54 · Surgery only | $245.47 | $245.47 | $380.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $50.12 | Facility | 56 · Pre-op care only | $32.36 | $33.11 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $229.09 | $229.09 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $512.86 | Professional | None | $263.03 | $346.74 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $363.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,318.26 | Professional | None | $645.65 | $870.96 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $776.25 Median $1,047.13 Typical High $1,584.89 | Professional | 22 · Increased work | $776.25 | $1,047.13 | $1,584.89 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,318.26 Typical High $1,995.26 | Professional | 50 · Both sides | $954.99 | $1,318.26 | $1,995.26 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $602.56 Typical High $933.25 | Professional | 54 · Surgery only | $446.68 | $602.56 | $933.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $87.10 Typical High $131.83 | Professional | 56 · Pre-op care only | $64.57 | $87.10 | $131.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $645.65 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $478.63 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Facility | None | $891.25 | $891.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $851.14 Typical High $1,380.38 | Professional | None | $407.38 | $851.14 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $676.08 Typical High $1,513.56 | Facility | None | $323.59 | $676.08 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $2,454.71 | Professional | None | $524.81 | $933.25 | $2,454.71 |
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 $338.84 Median $616.60 Typical High $954.99 | Professional | None | $338.84 | $616.60 | $954.99 |
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 $162.18 Median $165.96 Typical High $251.19 | Facility | 52 · Reduced service | $162.18 | $165.96 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $100.00 | Facility | 53 · Discontinued | $64.57 | $66.07 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $75.86 | Facility | 55 · Aftercare only | $48.98 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $186.21 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $77.62 |
Where North Dakota sits
The same service costs 4.5 times more in Colorado 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
CO $4,866MD $1,088
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.