How much rates vary
Facilitymedian $380 · 10th to 90th $240 to $2,570Professionalmedian $575 · 10th to 90th $372 to $871
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 $239.88 Median $371.54 Typical High $380.19 | Facility | None | $239.88 | $371.54 | $380.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $288.40 | Facility | 54 · Surgery only | $177.83 | $181.97 | $288.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $38.02 | Facility | 56 · Pre-op care only | $23.99 | $23.99 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $269.15 | Facility | 78 · Unplanned return to OR | $165.96 | $169.82 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $380.19 | Professional | None | $239.88 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $269.15 |
BCBS North Dakota Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $870.96 | Professional | None | $446.68 | $602.56 | $870.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $602.56 | Professional | 54 · Surgery only | $309.03 | $426.58 | $602.56 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $60.26 Typical High $87.10 | Professional | 56 · Pre-op care only | $44.67 | $60.26 | $87.10 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $457.09 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $331.13 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $741.31 | Facility | None | $645.65 | $645.65 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $1,000.00 | Professional | None | $354.81 | $602.56 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $524.81 Typical High $2,511.89 | Facility | None | $239.88 | $524.81 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $741.31 Typical High $1,778.28 | Professional | None | $389.05 | $741.31 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $794.33 | Professional | None | $245.47 | $457.09 | $794.33 |
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 $120.23 Median $120.23 Typical High $190.55 | Facility | 52 · Reduced service | $120.23 | $120.23 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $75.86 | Facility | 53 · Discontinued | $47.86 | $47.86 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $57.54 | Facility | 55 · Aftercare only | $35.48 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $147.91 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $44.67 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $44.67 | $57.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $537.03 Median $724.44 Typical High $1,047.13 | Professional | 22 · Increased work | $537.03 | $724.44 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $912.01 Typical High $1,318.26 | Professional | 50 · Both sides | $660.69 | $912.01 | $1,318.26 |
Where North Dakota sits
The same service costs 5.5 times more in Alaska than in Texas. 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.
North Dakota· 9th of 51
$550
AK $1,202TX $219
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.