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 $213.80 Median $234.42 Typical High $251.19 | Facility | None | $213.80 | $234.42 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $190.55 | Facility | 54 · Surgery only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | None | $213.80 | $234.42 | $251.19 |
BCBS Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $616.60 | Professional | None | $371.54 | $467.74 | $616.60 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $446.68 Median $562.34 Typical High $741.31 | Professional | 22 · Increased work | $446.68 | $562.34 | $741.31 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $436.52 | Professional | 54 · Surgery only | $263.03 | $331.13 | $436.52 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $501.19 | Facility | None | $436.52 | $436.52 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $676.08 | Professional | None | $302.00 | $467.74 | $676.08 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $251.19 Typical High $446.68 | Facility | None | $134.90 | $251.19 | $446.68 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $549.54 | Professional | None | $263.03 | $467.74 | $549.54 |
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 $223.87 Median $398.11 Typical High $501.19 | Professional | None | $223.87 | $398.11 | $501.19 |
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 $107.15 Median $107.15 Typical High $125.89 | Facility | 52 · Reduced service | $107.15 | $107.15 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $50.12 | Facility | 53 · Discontinued | $42.66 | $42.66 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $38.02 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $25.12 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $25.12 |
Where North Dakota sits
The same service costs 3.7 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.
North Dakota· 8th of 51
$437
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.