How much rates vary
Facilitymedian $1,995 · 10th to 90th $912 to $3,236Professionalmedian $1,660 · 10th to 90th $912 to $2,239
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $912.01 Median $912.01 Typical High $5,011.87 | Facility | None | $912.01 | $912.01 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,071.52 | Professional | None | $851.14 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $741.31 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,905.46 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,737.80 Median $2,290.87 Typical High $2,691.53 | Professional | 22 · Increased work | $1,737.80 | $2,290.87 | $2,691.53 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,318.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,023.29 | $1,318.26 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $144.54 | $190.55 | $223.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,412.54 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Facility | None | $1,513.56 | $1,513.56 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,398.83 | Professional | None | $954.99 | $1,698.24 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $3,235.94 | Facility | None | $912.01 | $1,995.26 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,584.89 Typical High $7,585.78 | Professional | None | $724.44 | $1,584.89 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $1,819.70 | Professional | None | $724.44 | $1,230.27 | $1,819.70 |
3 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 Professional Modifier 52 · Reduced service Typical Low $426.58 Median $457.09 Typical High $537.03 | Professional | 52 · Reduced service | $426.58 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $158.49 |
Where North Dakota sits
The same service costs 2.8 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.
Physician feeFacility fee
AK $7,236MD $2,555
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.