How much rates vary
Facilitymedian $331 · 10th to 90th $224 to $2,630Professionalmedian $490 · 10th to 90th $269 to $708
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 $223.87 Median $281.84 Typical High $2,187.76 | Facility | None | $223.87 | $281.84 | $2,187.76 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $208.93 | Facility | 54 · Surgery only | $169.82 | $169.82 | $208.93 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $331.13 | Professional | None | $218.78 | $275.42 | $331.13 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $724.44 | Professional | None | $416.87 | $537.03 | $724.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $501.19 Median $645.65 Typical High $870.96 | Professional | 22 · Increased work | $501.19 | $645.65 | $870.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $295.12 | $380.19 | $512.86 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Facility | None | $512.86 | $512.86 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $912.01 | Professional | None | $338.84 | $549.54 | $912.01 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $478.63 Typical High $2,630.27 | Facility | None | $223.87 | $478.63 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $602.56 | Professional | None | $281.84 | $478.63 | $602.56 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $537.03 | Professional | None | $234.42 | $416.87 | $537.03 |
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 $112.20 Median $112.20 Typical High $141.25 | Facility | 52 · Reduced service | $112.20 | $112.20 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $56.23 | Facility | 53 · Discontinued | $45.71 | $45.71 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $42.66 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $28.18 | Facility | 56 · Pre-op care only | $22.39 | $22.39 | $28.18 |
Where North Dakota sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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 $5,029WV $590
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.