How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $447Professionalmedian $417 · 10th to 90th $257 to $794
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 $169.82 Median $288.40 Typical High $288.40 | Facility | None | $169.82 | $288.40 | $288.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $213.80 | Facility | 54 · Surgery only | $128.82 | $128.82 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $295.12 | Professional | None | $169.82 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $158.49 | $218.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $812.83 | Professional | None | $331.13 | $489.78 | $812.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $588.84 Typical High $977.24 | Professional | 22 · Increased work | $398.11 | $588.84 | $977.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $346.74 Typical High $562.34 | Professional | 54 · Surgery only | $229.09 | $346.74 | $562.34 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $371.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $245.47 | $371.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $851.14 | Professional | None | $213.80 | $467.74 | $851.14 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $489.78 | Facility | None | $125.89 | $251.19 | $489.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $1,288.25 | Professional | None | $295.12 | $457.09 | $1,288.25 |
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 $177.83 Median $316.23 Typical High $549.54 | Professional | None | $177.83 | $316.23 | $549.54 |
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 $85.11 Median $87.10 Typical High $144.54 | Facility | 52 · Reduced service | $85.11 | $87.10 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $57.54 | Facility | 53 · Discontinued | $33.88 | $34.67 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $26.30 Typical High $42.66 | Facility | 55 · Aftercare only | $25.70 | $26.30 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $28.84 | Facility | 56 · Pre-op care only | $16.98 | $17.38 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $107.15 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $58.88 | Professional | 53 · Discontinued | $33.88 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $29.51 |
Where North Dakota sits
The same service costs 4.0 times more in Alaska 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.
North Dakota· 10th of 51
$389
AK $724MD $182
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.