How much rates vary
Facilitymedian $5,012 · 10th to 90th $437 to $8,913Professionalmedian $5,012 · 10th to 90th $589 to $10,715
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 $436.52 Median $5,011.87 Typical High $5,128.61 | Facility | None | $436.52 | $5,011.87 | $5,128.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $3,801.89 | Facility | 54 · Surgery only | $323.59 | $338.84 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $5,128.61 | Professional | None | $426.58 | $562.34 | $5,128.61 |
BCBS North Dakota Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $10,715.19 | Professional | None | $741.31 | $1,096.48 | $10,715.19 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $891.25 Median $1,318.26 Typical High $12,882.50 | Professional | 22 · Increased work | $891.25 | $1,318.26 | $12,882.50 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $776.25 Typical High $7,413.10 | Professional | 54 · Surgery only | $512.86 | $776.25 | $7,413.10 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $831.76 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $549.54 | $831.76 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $8,912.51 | Facility | None | $7,762.47 | $7,762.47 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $6,606.93 Typical High $13,803.84 | Professional | None | $588.84 | $6,606.93 | $13,803.84 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $5,011.87 Typical High $12,302.69 | Facility | None | $436.52 | $5,011.87 | $12,302.69 |
Medica Setting Professional Modifier None Typical Low $5,011.87 Median $8,912.51 Typical High $10,964.78 | Professional | None | $5,011.87 | $8,912.51 | $10,964.78 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $7,943.28 Typical High $12,302.69 | Facility | None | $3,981.07 | $7,943.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $457.09 Median $4,168.69 Typical High $9,549.93 | Professional | None | $457.09 | $4,168.69 | $9,549.93 |
4 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 $218.78 Median $223.87 Typical High $2,511.89 | Facility | 52 · Reduced service | $218.78 | $223.87 | $2,511.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $1,000.00 | Facility | 53 · Discontinued | $87.10 | $91.20 | $1,000.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $758.58 | Facility | 55 · Aftercare only | $64.57 | $67.61 | $758.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $501.19 | Facility | 56 · Pre-op care only | $43.65 | $45.71 | $501.19 |
Where North Dakota sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.