How much rates vary
Facilitymedian $389 · 10th to 90th $288 to $776Professionalmedian $617 · 10th to 90th $363 to $977
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 $288.40 Median $380.19 Typical High $389.05 | Facility | None | $288.40 | $380.19 | $389.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $288.40 | Facility | 54 · Surgery only | $213.80 | $213.80 | $288.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $38.90 | Facility | 56 · Pre-op care only | $28.84 | $28.84 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $524.81 | Professional | None | $223.87 | $323.59 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $199.53 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $31.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $31.62 | $38.90 |
BCBS North Dakota Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $977.24 | Professional | None | $478.63 | $691.83 | $977.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $575.44 Median $831.76 Typical High $1,148.15 | Professional | 22 · Increased work | $575.44 | $831.76 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $478.63 Typical High $676.08 | Professional | 54 · Surgery only | $331.13 | $478.63 | $676.08 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $69.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $47.86 | $69.18 | $97.72 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $512.86 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $354.81 | $512.86 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $812.83 | Facility | None | $707.95 | $707.95 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $1,096.48 | Professional | None | $309.03 | $630.96 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $851.14 | Facility | None | $288.40 | $489.78 | $851.14 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $4,897.79 | Professional | None | $389.05 | $724.44 | $4,897.79 |
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 $295.12 Median $524.81 Typical High $812.83 | Professional | None | $295.12 | $524.81 | $812.83 |
6 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 $141.25 Median $141.25 Typical High $194.98 | Facility | 52 · Reduced service | $141.25 | $141.25 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $77.62 | Facility | 53 · Discontinued | $57.54 | $57.54 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $57.54 | Facility | 55 · Aftercare only | $42.66 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $134.90 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $46.77 | $57.54 |
Where North Dakota sits
The same service costs 3.9 times more in Alaska than in New York. 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· 9th of 51
$603
AK $1,380NY $355
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.