How much rates vary
Facilitymedian $347 · 10th to 90th $224 to $1,202Professionalmedian $490 · 10th to 90th $263 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 $223.87 Median $338.84 Typical High $346.74 | Facility | None | $223.87 | $338.84 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $263.03 | Facility | 54 · Surgery only | $165.96 | $165.96 | $263.03 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $154.88 | $154.88 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $363.08 | Professional | None | $223.87 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $239.88 | $257.04 |
BCBS North Dakota Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $912.01 | Professional | None | $398.11 | $588.84 | $912.01 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $478.63 Median $707.95 Typical High $1,096.48 | Professional | 22 · Increased work | $478.63 | $707.95 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $407.38 Typical High $630.96 | Professional | 54 · Surgery only | $281.84 | $407.38 | $630.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $436.52 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $302.00 | $436.52 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Facility | None | $616.60 | $616.60 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $891.25 | Professional | None | $275.42 | $537.03 | $891.25 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $389.05 Typical High $1,096.48 | Facility | None | $223.87 | $389.05 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $2,630.27 | Professional | None | $288.40 | $562.34 | $2,630.27 |
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 $213.80 Median $380.19 Typical High $630.96 | Professional | None | $213.80 | $380.19 | $630.96 |
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 $112.20 Median $112.20 Typical High $173.78 | Facility | 52 · Reduced service | $112.20 | $112.20 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $69.18 | Facility | 53 · Discontinued | $44.67 | $44.67 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $52.48 | Facility | 55 · Aftercare only | $33.11 | $33.11 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $34.67 | Facility | 56 · Pre-op care only | $22.39 | $22.39 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $112.20 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $33.88 | $36.31 |
Where North Dakota sits
The same service costs 3.6 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· 10th of 51
$490
AK $912NJ $251
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.