How much rates vary
Facilitymedian $251 · 10th to 90th $151 to $447Professionalmedian $389 · 10th to 90th $200 to $631
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 $173.78 Median $251.19 Typical High $257.04 | Facility | None | $173.78 | $251.19 | $257.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $194.98 | Facility | 54 · Surgery only | $131.83 | $131.83 | $194.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $123.03 | $123.03 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $275.42 | Professional | None | $173.78 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $131.83 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $173.78 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $173.78 | $190.55 |
BCBS Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $630.96 | Professional | None | $323.59 | $457.09 | $630.96 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $389.05 Median $549.54 Typical High $758.58 | Professional | 22 · Increased work | $389.05 | $549.54 | $758.58 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $446.68 | Professional | 54 · Surgery only | $223.87 | $323.59 | $446.68 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $239.88 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Facility | None | $446.68 | $446.68 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $416.87 Typical High $660.69 | Professional | None | $199.53 | $416.87 | $660.69 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $257.04 Typical High $446.68 | Facility | None | $134.90 | $257.04 | $446.68 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $2,398.83 | Professional | None | $218.78 | $446.68 | $2,398.83 |
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 $165.96 Median $302.00 Typical High $501.19 | Professional | None | $165.96 | $302.00 | $501.19 |
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 $87.10 Median $87.10 Typical High $128.82 | Facility | 52 · Reduced service | $87.10 | $87.10 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | 53 · Discontinued | $35.48 | $35.48 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $38.90 | Facility | 55 · Aftercare only | $26.30 | $26.30 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $25.70 | Facility | 56 · Pre-op care only | $17.38 | $17.38 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $87.10 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $54.95 | Professional | 53 · Discontinued | $35.48 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $40.74 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $25.12 | $27.54 |
Where North Dakota sits
The same service costs 4.2 times more in Alaska than in Texas. 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· 10th of 51
$380
AK $741TX $178
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.