How much rates vary
Facilitymedian $457 · 10th to 90th $295 to $4,266Professionalmedian $708 · 10th to 90th $331 to $1,202
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 $295.12 Median $457.09 Typical High $457.09 | Facility | None | $295.12 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $45.71 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $524.81 | Professional | None | $295.12 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $29.51 | $43.65 | $47.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,202.26 | Professional | None | $602.56 | $812.83 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $977.24 Typical High $1,445.44 | Professional | 22 · Increased work | $707.95 | $977.24 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $81.28 Typical High $120.23 | Professional | 56 · Pre-op care only | $60.26 | $81.28 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Facility | None | $831.76 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $724.44 Typical High $1,202.26 | Professional | None | $338.84 | $724.44 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $4,265.80 | Facility | None | $295.12 | $524.81 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $3,467.37 | Professional | None | $389.05 | $691.83 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $794.33 | Professional | None | $257.04 | $489.78 | $794.33 |
10 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 $147.91 Median $147.91 Typical High $223.87 | Facility | 52 · Reduced service | $147.91 | $147.91 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $91.20 | Facility | 53 · Discontinued | $60.26 | $60.26 | $91.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $338.84 | Facility | 54 · Surgery only | $223.87 | $223.87 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $67.61 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $316.23 | Facility | 78 · Unplanned return to OR | $208.93 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $147.91 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $60.26 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $223.87 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $44.67 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $338.84 |
Where North Dakota sits
The same service costs 4.3 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· 7th of 51
$708
AK $1,259KY $295
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.