How much rates vary
Facilitymedian $1,995 · 10th to 90th $347 to $8,710Professionalmedian $1,995 · 10th to 90th $457 to $6,026
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 $346.74 Median $1,995.26 Typical High $23,988.33 | Facility | None | $346.74 | $1,995.26 | $23,988.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $1,479.11 | Facility | 54 · Surgery only | $257.04 | $281.84 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,380.38 Typical High $2,951.21 | Professional | None | $331.13 | $1,380.38 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $489.78 Typical High $1,698.24 | Professional | 54 · Surgery only | $257.04 | $489.78 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $5,370.32 | Professional | None | $660.69 | $1,023.29 | $5,370.32 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $1,230.27 Typical High $6,456.54 | Professional | 22 · Increased work | $794.33 | $1,230.27 | $6,456.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,513.56 Typical High $8,128.31 | Professional | 50 · Both sides | $977.24 | $1,513.56 | $8,128.31 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $707.95 Typical High $3,801.89 | Professional | 54 · Surgery only | $457.09 | $707.95 | $3,801.89 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,348.96 Typical High $4,786.30 | Professional | None | $416.87 | $1,348.96 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,995.26 Typical High $8,511.38 | Facility | None | $346.74 | $1,995.26 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $14,454.40 | Professional | None | $1,995.26 | $5,495.41 | $14,454.40 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,698.24 Typical High $3,801.89 | Professional | None | $371.54 | $1,698.24 | $3,801.89 |
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 $169.82 Median $186.21 Typical High $1,000.00 | Facility | 52 · Reduced service | $169.82 | $186.21 | $1,000.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $398.11 | Facility | 53 · Discontinued | $69.18 | $75.86 | $398.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $295.12 | Facility | 55 · Aftercare only | $51.29 | $56.23 | $295.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $199.53 | Facility | 56 · Pre-op care only | $34.67 | $38.02 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $323.59 Typical High $1,148.15 | Professional | 52 · Reduced service | $169.82 | $323.59 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $128.82 Typical High $457.09 | Professional | 53 · Discontinued | $69.18 | $128.82 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $97.72 Typical High $338.84 | Professional | 55 · Aftercare only | $51.29 | $97.72 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $64.57 Typical High $229.09 | Professional | 56 · Pre-op care only | $34.67 | $64.57 | $229.09 |
Where North Dakota sits
The same service costs 6.2 times more in Washington 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· 13th of 51
$1,995
WA $3,162MD $513
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.