How much rates vary
Facilitymedian $302 · 10th to 90th $182 to $759Professionalmedian $407 · 10th to 90th $186 to $832
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 $181.97 Median $302.00 Typical High $302.00 | Facility | None | $181.97 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $229.09 | Facility | 54 · Surgery only | $138.04 | $138.04 | $229.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $128.82 | $128.82 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $575.44 | Professional | None | $128.82 | $234.42 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $229.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $831.76 | Professional | None | $389.05 | $524.81 | $831.76 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $630.96 Typical High $1,000.00 | Professional | 22 · Increased work | $467.74 | $630.96 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $371.54 Typical High $588.84 | Professional | 54 · Surgery only | $269.15 | $371.54 | $588.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Facility | None | $549.54 | $549.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $467.74 Typical High $794.33 | Professional | None | $204.17 | $467.74 | $794.33 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $758.58 | Facility | None | $181.97 | $316.23 | $758.58 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $2,290.87 | Professional | None | $213.80 | $354.81 | $2,290.87 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $489.78 | Professional | None | $147.91 | $257.04 | $489.78 |
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 $91.20 Median $91.20 Typical High $151.36 | Facility | 52 · Reduced service | $91.20 | $91.20 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $60.26 | Facility | 53 · Discontinued | $36.31 | $36.31 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $45.71 | Facility | 55 · Aftercare only | $27.54 | $27.54 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $30.20 | Facility | 56 · Pre-op care only | $18.20 | $18.20 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $91.20 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $36.31 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $33.11 |
Where North Dakota sits
The same service costs 4.5 times more in Alaska 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
$398
AK $741KY $166
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.