How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $3,236Professionalmedian $1,380 · 10th to 90th $776 to $2,512
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 $588.84 Median $1,023.29 Typical High $1,023.29 | Facility | None | $588.84 | $1,023.29 | $1,023.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $776.25 | Facility | 54 · Surgery only | $436.52 | $457.09 | $776.25 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $102.33 | Facility | 56 · Pre-op care only | $58.88 | $60.26 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $724.44 | Facility | 78 · Unplanned return to OR | $407.38 | $426.58 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,174.90 | Professional | None | $588.84 | $831.76 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $436.52 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $74.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $58.88 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $724.44 |
BCBS North Dakota Setting Facility Modifier None Typical Low $2,630.27 Median $6,606.93 Typical High $7,079.46 | Facility | None | $2,630.27 | $6,606.93 | $7,079.46 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,584.89 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,096.48 Typical High $1,778.28 | Professional | 54 · Surgery only | $794.33 | $1,096.48 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $158.49 Typical High $251.19 | Professional | 56 · Pre-op care only | $112.20 | $158.49 | $251.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,174.90 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $851.14 | $1,174.90 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,737.80 | $1,737.80 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,754.23 | Professional | None | $870.96 | $1,621.81 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $3,235.94 | Facility | None | $588.84 | $1,778.28 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $5,128.61 | Professional | None | $1,047.13 | $1,905.46 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,041.74 | Professional | None | $602.56 | $1,148.15 | $2,041.74 |
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 $295.12 Median $302.00 Typical High $512.86 | Facility | 52 · Reduced service | $295.12 | $302.00 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $204.17 | Facility | 53 · Discontinued | $117.49 | $120.23 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $154.88 | Facility | 55 · Aftercare only | $89.13 | $91.20 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $371.54 Typical High $512.86 | Professional | 52 · Reduced service | $295.12 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $147.91 Typical High $204.17 | Professional | 53 · Discontinued | $117.49 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $154.88 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,348.96 Median $1,905.46 Typical High $3,019.95 | Professional | 22 · Increased work | $1,348.96 | $1,905.46 | $3,019.95 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,344.23 Typical High $3,801.89 | Professional | 50 · Both sides | $1,698.24 | $2,344.23 | $3,801.89 |
Where North Dakota sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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
AK $10,217WV $2,002
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.