How much rates vary
Facilitymedian $148 · 10th to 90th $107 to $1,202Professionalmedian $240 · 10th to 90th $115 to $363
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 $107.15 Median $141.25 Typical High $147.91 | Facility | None | $107.15 | $141.25 | $147.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $112.20 | Facility | 54 · Surgery only | $81.28 | $81.28 | $112.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $104.71 | Facility | 78 · Unplanned return to OR | $75.86 | $75.86 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $309.03 | Professional | None | $107.15 | $147.91 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $107.15 Typical High $117.49 | Professional | 54 · Surgery only | $81.28 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $100.00 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $75.86 | $100.00 | $109.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $363.08 | Professional | None | $204.17 | $269.15 | $363.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | 22 · Increased work | $245.47 | $323.59 | $436.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $141.25 | $190.55 | $257.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $204.17 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Facility | None | $257.04 | $257.04 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $380.19 | Professional | None | $120.23 | $251.19 | $380.19 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $1,096.48 | Facility | None | $107.15 | $190.55 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $275.42 Typical High $1,096.48 | Professional | None | $125.89 | $275.42 | $1,096.48 |
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 $100.00 Median $177.83 Typical High $295.12 | Professional | None | $100.00 | $177.83 | $295.12 |
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 $53.70 Median $53.70 Typical High $74.13 | Facility | 52 · Reduced service | $53.70 | $53.70 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $30.20 | Facility | 53 · Discontinued | $21.88 | $21.88 | $30.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $22.39 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $14.79 | Facility | 56 · Pre-op care only | $10.72 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $70.79 Typical High $77.62 | Professional | 52 · Reduced service | $53.70 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $30.90 | Professional | 53 · Discontinued | $21.88 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $23.44 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.13 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.72 | $14.13 | $15.49 |
Where North Dakota sits
The same service costs 4.0 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· 8th of 51
$240
AK $437NJ $110
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.