How much rates vary
Facilitymedian $117 · 10th to 90th $102 to $269Professionalmedian $234 · 10th to 90th $117 to $302
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 $102.33 Median $117.49 Typical High $117.49 | Facility | None | $102.33 | $117.49 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $87.10 | Facility | 54 · Surgery only | $75.86 | $83.18 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $11.75 | Facility | 56 · Pre-op care only | $10.23 | $10.96 | $11.75 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $77.62 Typical High $81.28 | Facility | 78 · Unplanned return to OR | $70.79 | $77.62 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $125.89 | Professional | None | $100.00 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $75.86 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $77.62 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $70.79 | $77.62 | $87.10 |
BCBS North Dakota Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $302.00 | Professional | None | $199.53 | $245.47 | $302.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $141.25 | $173.78 | $208.93 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $30.20 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $186.21 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $151.36 | $186.21 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Facility | None | $213.80 | $213.80 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $346.74 | Professional | None | $123.03 | $239.88 | $346.74 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $269.15 | Facility | None | $102.33 | $154.88 | $269.15 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $776.25 | Professional | None | $120.23 | $223.87 | $776.25 |
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 $104.71 Median $194.98 Typical High $234.42 | Professional | None | $104.71 | $194.98 | $234.42 |
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 $51.29 Median $54.95 Typical High $58.88 | Facility | 52 · Reduced service | $51.29 | $54.95 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $23.44 | Facility | 53 · Discontinued | $20.42 | $21.88 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $17.38 | Facility | 55 · Aftercare only | $15.14 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $51.29 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $18.62 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $239.88 Median $295.12 Typical High $363.08 | Professional | 22 · Increased work | $239.88 | $295.12 | $363.08 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $371.54 Typical High $446.68 | Professional | 50 · Both sides | $302.00 | $371.54 | $446.68 |
Where North Dakota sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 7th of 51
$224
AK $427FL $95.50
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.