How much rates vary
Facilitymedian $282 · 10th to 90th $182 to $562Professionalmedian $617 · 10th to 90th $309 to $832
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 $281.84 Median $309.03 Typical High $331.13 | Facility | None | $281.84 | $309.03 | $331.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $229.09 | Facility | 54 · Surgery only | $208.93 | $223.87 | $229.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $30.90 | Facility | 56 · Pre-op care only | $28.18 | $30.20 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $194.98 | $208.93 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $389.05 | Professional | None | $251.19 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $229.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $851.14 | Professional | None | $562.34 | $707.95 | $851.14 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $676.08 Median $851.14 Typical High $1,023.29 | Professional | 22 · Increased work | $676.08 | $851.14 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $1,288.25 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $389.05 | $489.78 | $602.56 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $56.23 | $70.79 | $85.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $524.81 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $416.87 | $524.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $645.65 | Facility | None | $562.34 | $562.34 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $645.65 Typical High $933.25 | Professional | None | $309.03 | $645.65 | $933.25 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $537.03 | Facility | None | $134.90 | $281.84 | $537.03 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $2,187.76 | Professional | None | $316.23 | $575.44 | $2,187.76 |
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 $288.40 Median $537.03 Typical High $630.96 | Professional | None | $288.40 | $537.03 | $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 $141.25 Median $151.36 Typical High $154.88 | Facility | 52 · Reduced service | $141.25 | $151.36 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $61.66 | Facility | 53 · Discontinued | $56.23 | $60.26 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $45.71 | Facility | 55 · Aftercare only | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $141.25 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $48.98 |
Where North Dakota sits
The same service costs 6.5 times more in Connecticut 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
CT $3,149MD $483
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.