How much rates vary
Facilitymedian $372 · 10th to 90th $275 to $1,202Professionalmedian $575 · 10th to 90th $295 to $891
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 $275.42 Median $354.81 Typical High $371.54 | Facility | None | $275.42 | $354.81 | $371.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $275.42 | Facility | 54 · Surgery only | $204.17 | $204.17 | $275.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $37.15 | Facility | 56 · Pre-op care only | $27.54 | $27.54 | $37.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $190.55 | $190.55 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $812.83 | Professional | None | $269.15 | $363.08 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $204.17 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $263.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $891.25 | Professional | None | $489.78 | $660.69 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $588.84 Median $794.33 Typical High $1,071.52 | Professional | 22 · Increased work | $588.84 | $794.33 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $457.09 Typical High $630.96 | Professional | 54 · Surgery only | $338.84 | $457.09 | $630.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $48.98 | $66.07 | $89.13 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $489.78 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $363.08 | $489.78 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $724.44 | Facility | None | $630.96 | $630.96 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $912.01 | Professional | None | $302.00 | $630.96 | $912.01 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $512.86 Typical High $1,202.26 | Facility | None | $275.42 | $512.86 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $676.08 Typical High $2,691.53 | Professional | None | $309.03 | $676.08 | $2,691.53 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $741.31 | Professional | None | $251.19 | $446.68 | $741.31 |
6 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 $138.04 Median $138.04 Typical High $186.21 | Facility | 52 · Reduced service | $138.04 | $138.04 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $74.13 | Facility | 53 · Discontinued | $54.95 | $54.95 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $54.95 | Facility | 55 · Aftercare only | $40.74 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $177.83 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $52.48 | $57.54 |
Where North Dakota sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 7th of 51
$575
AK $1,072NJ $263
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.