How much rates vary
Facilitymedian $479 · 10th to 90th $182 to $891Professionalmedian $1,072 · 10th to 90th $525 to $1,445
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 $524.81 Typical High $524.81 | Facility | None | $478.63 | $524.81 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Facility | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Facility | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $524.81 | Professional | None | $478.63 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $371.54 |
BCBS North Dakota Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,479.11 | Professional | None | $954.99 | $1,230.27 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $870.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $660.69 | $870.96 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $95.50 | $123.03 | $147.91 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $707.95 | $933.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Facility | None | $891.25 | $891.25 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $1,513.56 | Professional | None | $512.86 | $1,023.29 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $478.63 Typical High $891.25 | Facility | None | $134.90 | $478.63 | $891.25 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $977.24 Typical High $3,548.13 | Professional | None | $537.03 | $977.24 | $3,548.13 |
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 $501.19 Median $891.25 Typical High $1,071.52 | Professional | None | $501.19 | $891.25 | $1,071.52 |
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 $239.88 Median $239.88 Typical High $263.03 | Facility | 52 · Reduced service | $239.88 | $239.88 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $104.71 | Facility | 53 · Discontinued | $95.50 | $95.50 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $79.43 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,148.15 Median $1,479.11 Typical High $1,778.28 | Professional | 22 · Increased work | $1,148.15 | $1,479.11 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,862.09 Typical High $2,238.72 | Professional | 50 · Both sides | $1,412.54 | $1,862.09 | $2,238.72 |
Where North Dakota sits
The same service costs 5.2 times more in Connecticut than in Delaware. 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
CT $3,468DE $666
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.