How much rates vary
Facilitymedian $1,349 · 10th to 90th $234 to $1,862Professionalmedian $1,349 · 10th to 90th $316 to $4,074
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 $234.42 Median $1,348.96 Typical High $1,348.96 | Facility | None | $234.42 | $1,348.96 | $1,348.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $1,000.00 | Facility | 54 · Surgery only | $173.78 | $190.55 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $1,096.48 Typical High $1,778.28 | Professional | None | $223.87 | $1,096.48 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $331.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $173.78 | $331.13 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $3,630.78 | Professional | None | $446.68 | $691.83 | $3,630.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $537.03 Median $831.76 Typical High $4,365.16 | Professional | 22 · Increased work | $537.03 | $831.76 | $4,365.16 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $1,047.13 Typical High $5,370.32 | Professional | 50 · Both sides | $676.08 | $1,047.13 | $5,370.32 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $2,511.89 | Professional | 54 · Surgery only | $316.23 | $489.78 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $524.81 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $338.84 | $524.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $1,148.15 Typical High $3,162.28 | Professional | None | $288.40 | $1,148.15 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $691.83 Typical High $2,290.87 | Facility | None | $234.42 | $691.83 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $3,715.35 Typical High $9,332.54 | Professional | None | $1,412.54 | $3,715.35 | $9,332.54 |
United Setting Professional Modifier None Typical Low $251.19 Median $1,148.15 Typical High $2,570.40 | Professional | None | $251.19 | $1,148.15 | $2,570.40 |
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 $114.82 Median $125.89 Typical High $676.08 | Facility | 52 · Reduced service | $114.82 | $125.89 | $676.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $269.15 | Facility | 53 · Discontinued | $46.77 | $51.29 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $199.53 | Facility | 55 · Aftercare only | $34.67 | $38.02 | $199.53 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $134.90 | Facility | 56 · Pre-op care only | $23.44 | $25.70 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $218.78 Typical High $741.31 | Professional | 52 · Reduced service | $114.82 | $218.78 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $89.13 Typical High $302.00 | Professional | 53 · Discontinued | $46.77 | $89.13 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $66.07 Typical High $223.87 | Professional | 55 · Aftercare only | $34.67 | $66.07 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $43.65 Typical High $147.91 | Professional | 56 · Pre-op care only | $23.44 | $43.65 | $147.91 |
Where North Dakota sits
The same service costs 6.5 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· 14th of 51
$1,349
WA $2,138MD $331
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.