How much rates vary
Facilitymedian $417 · 10th to 90th $182 to $813Professionalmedian $933 · 10th to 90th $457 to $1,259
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 $416.87 Median $457.09 Typical High $457.09 | Facility | None | $416.87 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $346.74 | Facility | 54 · Surgery only | $316.23 | $331.13 | $346.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $45.71 | Facility | 56 · Pre-op care only | $41.69 | $43.65 | $45.71 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $295.12 | $309.03 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | None | $407.38 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $316.23 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $338.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,258.93 | Professional | None | $831.76 | $1,023.29 | $1,258.93 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $724.44 Typical High $891.25 | Professional | 54 · Surgery only | $575.44 | $724.44 | $891.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $125.89 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Facility | None | $831.76 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $954.99 Typical High $1,380.38 | Professional | None | $446.68 | $954.99 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $416.87 Typical High $812.83 | Facility | None | $134.90 | $416.87 | $812.83 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $3,235.94 | Professional | None | $478.63 | $831.76 | $3,235.94 |
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 $436.52 Median $741.31 Typical High $933.25 | Professional | None | $436.52 | $741.31 | $933.25 |
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 $208.93 Median $218.78 Typical High $229.09 | Facility | 52 · Reduced service | $208.93 | $218.78 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $91.20 | Facility | 53 · Discontinued | $83.18 | $89.13 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $69.18 | Facility | 55 · Aftercare only | $63.10 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $74.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $977.24 Median $1,230.27 Typical High $1,513.56 | Professional | 22 · Increased work | $977.24 | $1,230.27 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,548.82 Typical High $1,905.46 | Professional | 50 · Both sides | $1,230.27 | $1,548.82 | $1,905.46 |
Where North Dakota sits
The same service costs 5.3 times more in Colorado than in Florida. 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 $4,377FL $831
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.