How much rates vary
Facilitymedian $219 · 10th to 90th $135 to $275Professionalmedian $355 · 10th to 90th $219 to $603
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 $134.90 Median $138.04 Typical High $218.78 | Facility | None | $134.90 | $138.04 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $263.03 | Professional | None | $134.90 | $218.78 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $616.60 | Professional | None | $263.03 | $389.05 | $616.60 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $316.23 Median $467.74 Typical High $741.31 | Professional | 22 · Increased work | $316.23 | $467.74 | $741.31 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $275.42 Typical High $426.58 | Professional | 54 · Surgery only | $181.97 | $275.42 | $426.58 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $194.98 | $295.12 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $467.74 | Facility | None | $407.38 | $407.38 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $645.65 | Professional | None | $190.55 | $363.08 | $645.65 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $218.78 Typical High $371.54 | Facility | None | $125.89 | $218.78 | $371.54 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $426.58 Typical High $1,023.29 | Professional | None | $223.87 | $426.58 | $1,023.29 |
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 $141.25 Median $263.03 Typical High $436.52 | Professional | None | $141.25 | $263.03 | $436.52 |
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 $67.61 Median $69.18 Typical High $109.65 | Facility | 52 · Reduced service | $67.61 | $69.18 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $43.65 | Facility | 53 · Discontinued | $26.92 | $27.54 | $43.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $32.36 | Facility | 55 · Aftercare only | $20.42 | $20.42 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $21.88 | Facility | 56 · Pre-op care only | $13.49 | $13.80 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $83.18 Typical High $112.20 | Professional | 52 · Reduced service | $67.61 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.11 Typical High $44.67 | Professional | 53 · Discontinued | $26.92 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.12 Typical High $33.88 | Professional | 55 · Aftercare only | $20.42 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.60 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.49 | $16.60 | $22.39 |
Where North Dakota sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.