How much rates vary
Facilitymedian $120 · 10th to 90th $91 to $269Professionalmedian $234 · 10th to 90th $115 to $347
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 $91.20 Median $120.23 Typical High $120.23 | Facility | None | $91.20 | $120.23 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $70.79 Typical High $89.13 | Facility | 54 · Surgery only | $67.61 | $70.79 | $89.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $66.07 Typical High $83.18 | Facility | 78 · Unplanned return to OR | $63.10 | $66.07 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $131.83 | Professional | None | $87.10 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $77.62 Typical High $93.33 | Professional | 54 · Surgery only | $67.61 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $72.44 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $63.10 | $72.44 | $87.10 |
BCBS North Dakota Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | None | $199.53 | $263.03 | $354.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $239.88 Median $316.23 Typical High $426.58 | Professional | 22 · Increased work | $239.88 | $316.23 | $426.58 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $181.97 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $181.97 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $151.36 | $194.98 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $257.04 | Facility | None | $223.87 | $223.87 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $346.74 | Professional | None | $117.49 | $213.80 | $346.74 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $269.15 | Facility | None | $91.20 | $125.89 | $269.15 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $707.95 | Professional | None | $123.03 | $234.42 | $707.95 |
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 $95.50 Median $169.82 Typical High $234.42 | Professional | None | $95.50 | $169.82 | $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 $44.67 Median $47.86 Typical High $60.26 | Facility | 52 · Reduced service | $44.67 | $47.86 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $19.05 Typical High $23.99 | Facility | 53 · Discontinued | $18.20 | $19.05 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $17.78 | Facility | 55 · Aftercare only | $13.49 | $14.13 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $12.02 | Facility | 56 · Pre-op care only | $9.12 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $44.67 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $18.20 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $12.59 |
Where North Dakota sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.