How much rates vary
Facilitymedian $302 · 10th to 90th $195 to $1,202Professionalmedian $447 · 10th to 90th $209 to $759
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 $194.98 Median $302.00 Typical High $302.00 | Facility | None | $194.98 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $229.09 | Facility | 54 · Surgery only | $144.54 | $144.54 | $229.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $134.90 | $134.90 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $323.59 | Professional | None | $194.98 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $144.54 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $134.90 | $208.93 | $229.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $776.25 | Professional | None | $380.19 | $512.86 | $776.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $616.60 Typical High $933.25 | Professional | 22 · Increased work | $457.09 | $616.60 | $933.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $363.08 Typical High $537.03 | Professional | 54 · Surgery only | $269.15 | $363.08 | $537.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Facility | None | $537.03 | $537.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $776.25 | Professional | None | $213.80 | $467.74 | $776.25 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $338.84 Typical High $1,096.48 | Facility | None | $194.98 | $338.84 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $2,290.87 | Professional | None | $251.19 | $457.09 | $2,290.87 |
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 $162.18 Median $316.23 Typical High $524.81 | Professional | None | $162.18 | $316.23 | $524.81 |
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 $97.72 Median $97.72 Typical High $151.36 | Facility | 52 · Reduced service | $97.72 | $97.72 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $60.26 | Facility | 53 · Discontinued | $38.90 | $38.90 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $45.71 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $30.20 | Facility | 56 · Pre-op care only | $19.50 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $97.72 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $38.90 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $28.84 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.50 | $30.20 | $32.36 |
Where North Dakota sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 9th of 51
$447
AK $794KY $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.