How much rates vary
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 $102.33 Median $141.25 Typical High $144.54 | Facility | None | $102.33 | $141.25 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $109.65 | Facility | 54 · Surgery only | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $177.83 | Professional | None | $91.20 | $134.90 | $177.83 |
BCBS Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
BCBS Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $363.08 | Professional | None | $177.83 | $257.04 | $363.08 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $213.80 Median $309.03 Typical High $436.52 | Professional | 22 · Increased work | $213.80 | $309.03 | $436.52 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $123.03 | $177.83 | $257.04 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Facility | None | $257.04 | $257.04 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $467.74 | Professional | None | $141.25 | $251.19 | $467.74 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $269.15 | Facility | None | $102.33 | $144.54 | $269.15 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $316.23 | Professional | None | $151.36 | $251.19 | $316.23 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $269.15 | Professional | None | $107.15 | $190.55 | $269.15 |
4 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 $50.12 Median $50.12 Typical High $72.44 | Facility | 52 · Reduced service | $50.12 | $50.12 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $28.84 | Facility | 53 · Discontinued | $20.42 | $20.42 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $21.88 | Facility | 55 · Aftercare only | $15.14 | $15.14 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $14.45 | Facility | 56 · Pre-op care only | $10.23 | $10.23 | $14.45 |
Where North Dakota sits
The same service costs 3.2 times more in Wisconsin 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· 8th of 51
$219
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.