How much rates vary
Facilitymedian $977 · 10th to 90th $85 to $1,698Professionalmedian $977 · 10th to 90th $115 to $2,399
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 $85.11 Median $891.25 Typical High $977.24 | Facility | None | $85.11 | $891.25 | $977.24 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $741.31 | Facility | 54 · Surgery only | $63.10 | $63.10 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $457.09 Typical High $977.24 | Professional | None | $85.11 | $457.09 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $338.84 Typical High $741.31 | Professional | 54 · Surgery only | $63.10 | $338.84 | $741.31 |
BCBS North Dakota Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $2,398.83 | Professional | None | $158.49 | $245.47 | $2,398.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $190.55 Median $288.40 Typical High $2,884.03 | Professional | 22 · Increased work | $190.55 | $288.40 | $2,884.03 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $169.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $112.20 | $169.82 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $181.97 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $120.23 | $181.97 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,621.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $776.25 Typical High $2,344.23 | Professional | None | $104.71 | $776.25 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $977.24 Typical High $1,698.24 | Facility | None | $85.11 | $977.24 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,659.59 Typical High $6,918.31 | Professional | None | $812.83 | $1,659.59 | $6,918.31 |
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 $81.28 Median $575.44 Typical High $1,819.70 | Professional | None | $81.28 | $575.44 | $1,819.70 |
7 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 $42.66 Median $42.66 Typical High $489.78 | Facility | 52 · Reduced service | $42.66 | $42.66 | $489.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $194.98 | Facility | 53 · Discontinued | $16.98 | $16.98 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $147.91 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $229.09 Typical High $489.78 | Professional | 52 · Reduced service | $42.66 | $229.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $91.20 Typical High $194.98 | Professional | 53 · Discontinued | $16.98 | $91.20 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $67.61 Typical High $147.91 | Professional | 55 · Aftercare only | $12.59 | $67.61 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $45.71 Typical High $97.72 | Professional | 56 · Pre-op care only | $8.51 | $45.71 | $97.72 |
Where North Dakota sits
The same service costs 14.1 times more in Washington than in Kentucky. 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
$977
WA $1,288KY $91.20
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.