How much rates vary
Facilitymedian $708 · 10th to 90th $417 to $2,754Professionalmedian $912 · 10th to 90th $501 to $1,288
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 $416.87 Median $524.81 Typical High $4,365.16 | Facility | None | $416.87 | $524.81 | $4,365.16 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $389.05 | Facility | 54 · Surgery only | $309.03 | $316.23 | $389.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $288.40 | $295.12 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $588.84 | Professional | None | $407.38 | $489.78 | $588.84 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
BCBS North Dakota Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,348.96 | Professional | None | $758.58 | $977.24 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $912.01 Median $1,174.90 Typical High $1,621.81 | Professional | 22 · Increased work | $912.01 | $1,174.90 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,479.11 Typical High $1,995.26 | Professional | 50 · Both sides | $1,122.02 | $1,479.11 | $1,995.26 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $676.08 Typical High $933.25 | Professional | 54 · Surgery only | $524.81 | $676.08 | $933.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $724.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $562.34 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Facility | None | $891.25 | $891.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,584.89 | Professional | None | $602.56 | $977.24 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $912.01 Typical High $2,754.23 | Facility | None | $416.87 | $912.01 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,122.02 | Professional | None | $549.54 | $954.99 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $1,023.29 | Professional | None | $436.52 | $776.25 | $1,023.29 |
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 $208.93 Median $208.93 Typical High $263.03 | Facility | 52 · Reduced service | $208.93 | $208.93 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $104.71 | Facility | 53 · Discontinued | $83.18 | $83.18 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $77.62 | Facility | 55 · Aftercare only | $61.66 | $63.10 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $52.48 | Facility | 56 · Pre-op care only | $41.69 | $41.69 | $52.48 |
Where North Dakota sits
The same service costs 5.4 times more in Wisconsin than in West Virginia. 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
WI $6,411WV $1,178
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.