How much rates vary
Facilitymedian $275 · 10th to 90th $135 to $479Professionalmedian $631 · 10th to 90th $316 to $891
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 $275.42 Median $316.23 Typical High $316.23 | Facility | None | $275.42 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $239.88 | Facility | 54 · Surgery only | $204.17 | $213.80 | $239.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $31.62 | Facility | 56 · Pre-op care only | $27.54 | $28.84 | $31.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $190.55 | $199.53 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $338.84 | Professional | None | $269.15 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $204.17 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $190.55 | $199.53 | $239.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $891.25 | Professional | None | $575.44 | $724.44 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $691.83 Median $870.96 Typical High $1,071.52 | Professional | 22 · Increased work | $691.83 | $870.96 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $512.86 | $630.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $57.54 | $72.44 | $89.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $676.08 | Facility | None | $575.44 | $575.44 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $912.01 | Professional | None | $316.23 | $630.96 | $912.01 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $275.42 Typical High $537.03 | Facility | None | $134.90 | $275.42 | $537.03 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $2,089.30 | Professional | None | $331.13 | $616.60 | $2,089.30 |
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 $281.84 Median $524.81 Typical High $630.96 | Professional | None | $281.84 | $524.81 | $630.96 |
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 $134.90 Median $144.54 Typical High $158.49 | Facility | 52 · Reduced service | $134.90 | $144.54 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $63.10 | Facility | 53 · Discontinued | $54.95 | $57.54 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $47.86 | Facility | 55 · Aftercare only | $40.74 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $134.90 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $54.95 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $51.29 |
Where North Dakota sits
The same service costs 6.7 times more in New York 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
NY $2,828FL $419
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.