How much rates vary
Facilitymedian $214 · 10th to 90th $155 to $1,202Professionalmedian $331 · 10th to 90th $170 to $525
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 $154.88 Median $208.93 Typical High $213.80 | Facility | None | $154.88 | $208.93 | $213.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $162.18 | Facility | 54 · Surgery only | $114.82 | $114.82 | $162.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $288.40 | Professional | None | $154.88 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $114.82 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $158.49 |
BCBS North Dakota Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $524.81 | Professional | None | $281.84 | $380.19 | $524.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $338.84 Median $457.09 Typical High $630.96 | Professional | 22 · Increased work | $338.84 | $457.09 | $630.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $363.08 | Professional | 54 · Surgery only | $199.53 | $263.03 | $363.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $213.80 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Facility | None | $371.54 | $371.54 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $537.03 | Professional | None | $169.82 | $363.08 | $537.03 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $309.03 Typical High $1,202.26 | Facility | None | $154.88 | $309.03 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $1,621.81 | Professional | None | $181.97 | $380.19 | $1,621.81 |
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 $141.25 Median $251.19 Typical High $426.58 | Professional | None | $141.25 | $251.19 | $426.58 |
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 $75.86 Median $75.86 Typical High $107.15 | Facility | 52 · Reduced service | $75.86 | $75.86 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $42.66 | Facility | 53 · Discontinued | $30.90 | $30.90 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $32.36 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $21.38 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $104.71 Typical High $112.20 | Professional | 52 · Reduced service | $75.86 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $20.89 | $22.39 |
Where North Dakota sits
The same service costs 4.2 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
$331
AK $646NJ $155
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.