How much rates vary
Facilitymedian $617 · 10th to 90th $120 to $1,549Professionalmedian $1,202 · 10th to 90th $158 to $2,884
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 $120.23 Median $1,202.26 Typical High $1,202.26 | Facility | None | $120.23 | $1,202.26 | $1,202.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $891.25 | Facility | 54 · Surgery only | $91.20 | $91.20 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $645.65 Typical High $2,137.96 | Professional | None | $117.49 | $645.65 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $489.78 Typical High $891.25 | Professional | 54 · Surgery only | $89.13 | $489.78 | $891.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $2,951.21 | Professional | None | $208.93 | $338.84 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $251.19 Median $407.38 Typical High $3,548.13 | Professional | 22 · Increased work | $251.19 | $407.38 | $3,548.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $2,041.74 | Professional | 54 · Surgery only | $147.91 | $234.42 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $251.19 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $158.49 | $251.19 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Facility | None | $2,137.96 | $2,137.96 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $933.25 Typical High $3,090.30 | Professional | None | $154.88 | $933.25 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $616.60 Typical High $1,737.80 | Facility | None | $120.23 | $616.60 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $9,120.11 | Professional | None | $1,000.00 | $1,778.28 | $9,120.11 |
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 $125.89 Median $794.33 Typical High $1,995.26 | Professional | None | $125.89 | $794.33 | $1,995.26 |
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 $60.26 Median $60.26 Typical High $602.56 | Facility | 52 · Reduced service | $60.26 | $60.26 | $602.56 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $239.88 | Facility | 53 · Discontinued | $23.99 | $23.99 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $181.97 | Facility | 55 · Aftercare only | $18.20 | $18.20 | $181.97 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $120.23 | Facility | 56 · Pre-op care only | $12.02 | $12.02 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $323.59 Typical High $602.56 | Professional | 52 · Reduced service | $60.26 | $323.59 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $131.83 Typical High $239.88 | Professional | 53 · Discontinued | $23.99 | $131.83 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $97.72 Typical High $181.97 | Professional | 55 · Aftercare only | $17.78 | $97.72 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $64.57 Typical High $120.23 | Professional | 56 · Pre-op care only | $12.02 | $64.57 | $120.23 |
Where North Dakota sits
The same service costs 5.5 times more in Hawaii 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
HI $4,440MD $808
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.