How much rates vary
Facilitymedian $195 · 10th to 90th $81 to $1,202Professionalmedian $200 · 10th to 90th $107 to $479
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 $81.28 Median $186.21 Typical High $194.98 | Facility | None | $81.28 | $186.21 | $194.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $144.54 | Facility | 54 · Surgery only | $61.66 | $61.66 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $275.42 | Professional | None | $81.28 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $131.83 Typical High $147.91 | Professional | 54 · Surgery only | $61.66 | $131.83 | $147.91 |
BCBS North Dakota Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $478.63 | Professional | None | $138.04 | $234.42 | $478.63 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $162.18 Median $281.84 Typical High $575.44 | Professional | 22 · Increased work | $162.18 | $281.84 | $575.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $162.18 Typical High $338.84 | Professional | 54 · Surgery only | $95.50 | $162.18 | $338.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $173.78 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $102.33 | $173.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $389.05 | Facility | None | $338.84 | $338.84 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $213.80 Typical High $489.78 | Professional | None | $109.65 | $213.80 | $489.78 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $245.47 Typical High $1,202.26 | Facility | None | $81.28 | $245.47 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $1,412.54 | Professional | None | $165.96 | $338.84 | $1,412.54 |
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 $87.10 Median $165.96 Typical High $380.19 | Professional | None | $87.10 | $165.96 | $380.19 |
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 $40.74 Median $40.74 Typical High $97.72 | Facility | 52 · Reduced service | $40.74 | $40.74 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $38.90 | Facility | 53 · Discontinued | $16.22 | $16.22 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $29.51 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $19.50 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $40.74 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $35.48 Typical High $39.81 | Professional | 53 · Discontinued | $16.22 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $12.30 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $17.78 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.13 | $17.78 | $19.95 |
Where North Dakota sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 18th of 51
$200
AK $355MD $95.50
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.