How much rates vary
Facilitymedian $468 · 10th to 90th $339 to $2,570Professionalmedian $708 · 10th to 90th $363 to $1,148
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 $338.84 Median $436.52 Typical High $467.74 | Facility | None | $338.84 | $436.52 | $467.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $354.81 | Facility | 54 · Surgery only | $257.04 | $257.04 | $354.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $46.77 | Facility | 56 · Pre-op care only | $33.88 | $33.88 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $239.88 | $239.88 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $891.25 | Professional | None | $338.84 | $467.74 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $239.88 | $302.00 | $331.13 |
BCBS Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,148.15 | Professional | None | $602.56 | $831.76 | $1,148.15 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $724.44 Median $1,000.00 Typical High $1,380.38 | Professional | 22 · Increased work | $724.44 | $1,000.00 | $1,380.38 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $575.44 Typical High $794.33 | Professional | 54 · Surgery only | $426.58 | $575.44 | $794.33 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $83.18 Typical High $114.82 | Professional | 56 · Pre-op care only | $60.26 | $83.18 | $114.82 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $616.60 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $457.09 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Facility | None | $776.25 | $776.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $758.58 Typical High $1,148.15 | Professional | None | $371.54 | $758.58 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $645.65 Typical High $2,511.89 | Facility | None | $338.84 | $645.65 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $851.14 Typical High $3,311.31 | Professional | None | $398.11 | $851.14 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $933.25 | Professional | None | $316.23 | $562.34 | $933.25 |
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 $169.82 Median $169.82 Typical High $234.42 | Facility | 52 · Reduced service | $169.82 | $169.82 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $93.33 | Facility | 53 · Discontinued | $67.61 | $67.61 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $70.79 | Facility | 55 · Aftercare only | $51.29 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $169.82 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $67.61 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $72.44 |
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
$708
AK $1,318NJ $331
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.