How much rates vary
Facilitymedian $182 · 10th to 90th $110 to $309Professionalmedian $240 · 10th to 90th $129 to $447
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 $109.65 Median $169.82 Typical High $181.97 | Facility | None | $109.65 | $169.82 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $134.90 | Facility | 54 · Surgery only | $83.18 | $83.18 | $134.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $77.62 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $77.62 | $77.62 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $186.21 | Professional | None | $109.65 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $128.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $446.68 | Professional | None | $194.98 | $288.40 | $446.68 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $234.42 Median $338.84 Typical High $537.03 | Professional | 22 · Increased work | $234.42 | $338.84 | $537.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $316.23 | Professional | 54 · Surgery only | $138.04 | $199.53 | $316.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $354.81 | Facility | None | $309.03 | $309.03 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $446.68 | Professional | None | $134.90 | $263.03 | $446.68 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $309.03 | Facility | None | $109.65 | $181.97 | $309.03 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $1,318.26 | Professional | None | $144.54 | $295.12 | $1,318.26 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $331.13 | Professional | None | $102.33 | $194.98 | $331.13 |
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 $54.95 Median $54.95 Typical High $91.20 | Facility | 52 · Reduced service | $54.95 | $54.95 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $36.31 | Facility | 53 · Discontinued | $21.88 | $21.88 | $36.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $26.92 | Facility | 55 · Aftercare only | $16.60 | $16.60 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $18.20 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $54.95 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $21.88 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.96 | $16.98 | $18.62 |
Where North Dakota sits
The same service costs 3.5 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· 11th of 51
$240
AK $437NJ $126
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.