How much rates vary
Facilitymedian $355 · 10th to 90th $182 to $676Professionalmedian $871 · 10th to 90th $389 to $1,202
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 $354.81 Median $389.05 Typical High $416.87 | Facility | None | $354.81 | $389.05 | $416.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $295.12 | Facility | 54 · Surgery only | $263.03 | $295.12 | $295.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $38.90 | Facility | 56 · Pre-op care only | $35.48 | $38.90 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $467.74 | Professional | None | $331.13 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $323.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,230.27 | Professional | None | $794.33 | $977.24 | $1,230.27 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $549.54 | $676.08 | $851.14 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $123.03 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $123.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Facility | None | $794.33 | $794.33 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,318.26 | Professional | None | $426.58 | $912.01 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $354.81 Typical High $676.08 | Facility | None | $134.90 | $354.81 | $676.08 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $3,090.30 | Professional | None | $398.11 | $758.58 | $3,090.30 |
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 $363.08 Median $676.08 Typical High $794.33 | Professional | None | $363.08 | $676.08 | $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 $177.83 Median $194.98 Typical High $194.98 | Facility | 52 · Reduced service | $177.83 | $194.98 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Facility | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $58.88 | Facility | 55 · Aftercare only | $52.48 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $69.18 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $954.99 Median $1,174.90 Typical High $1,479.11 | Professional | 22 · Increased work | $954.99 | $1,174.90 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,445.44 Typical High $1,819.70 | Professional | 50 · Both sides | $1,202.26 | $1,445.44 | $1,819.70 |
Where North Dakota sits
The same service costs 5.3 times more in New York 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
NY $3,063DE $576
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.