How much rates vary
Facilitymedian $871 · 10th to 90th $646 to $5,370Professionalmedian $1,445 · 10th to 90th $813 to $2,138
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 $645.65 Median $851.14 Typical High $870.96 | Facility | None | $645.65 | $851.14 | $870.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $645.65 | Facility | 54 · Surgery only | $489.78 | $489.78 | $645.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $87.10 | Facility | 56 · Pre-op care only | $64.57 | $64.57 | $87.10 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $602.56 | Facility | 78 · Unplanned return to OR | $457.09 | $457.09 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $977.24 | Professional | None | $645.65 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $562.34 | $602.56 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,621.81 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,122.02 Typical High $1,513.56 | Professional | 54 · Surgery only | $851.14 | $1,122.02 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $162.18 Typical High $213.80 | Professional | 56 · Pre-op care only | $123.03 | $162.18 | $213.80 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,202.26 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $912.01 | $1,202.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,659.59 | Facility | None | $1,445.44 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $2,290.87 | Professional | None | $812.83 | $1,412.54 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $5,248.07 | Facility | None | $645.65 | $1,202.26 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $4,897.79 | Professional | None | $891.25 | $1,659.59 | $4,897.79 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,495.41 | Facility | None | $3,235.94 | $4,897.79 | $5,495.41 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,778.28 | Professional | None | $676.08 | $1,258.93 | $1,778.28 |
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 $323.59 Median $323.59 Typical High $426.58 | Facility | 52 · Reduced service | $323.59 | $323.59 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $173.78 | Facility | 53 · Discontinued | $128.82 | $131.83 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $128.82 | Facility | 55 · Aftercare only | $97.72 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $128.82 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $120.23 | $128.82 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,479.11 Median $1,949.84 Typical High $2,570.40 | Professional | 22 · Increased work | $1,479.11 | $1,949.84 | $2,570.40 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,398.83 Typical High $3,235.94 | Professional | 50 · Both sides | $1,819.70 | $2,398.83 | $3,235.94 |
Where North Dakota sits
The same service costs 6.4 times more in Colorado than in Hawaii. 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
CO $13,837HI $2,150
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.