How much rates vary
Facilitymedian $759 · 10th to 90th $468 to $2,570Professionalmedian $1,202 · 10th to 90th $708 to $1,995
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 $467.74 Median $741.31 Typical High $758.58 | Facility | None | $467.74 | $741.31 | $758.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $575.44 | Facility | 54 · Surgery only | $346.74 | $346.74 | $575.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $537.03 | Facility | 78 · Unplanned return to OR | $323.59 | $323.59 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $758.58 | Professional | None | $467.74 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $346.74 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $323.59 | $426.58 | $537.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $891.25 | $1,288.25 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,071.52 Median $1,548.82 Typical High $2,454.71 | Professional | 22 · Increased work | $1,071.52 | $1,548.82 | $2,454.71 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,905.46 Typical High $3,019.95 | Professional | 50 · Both sides | $1,348.96 | $1,905.46 | $3,019.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $891.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $630.96 | $891.25 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $676.08 | $954.99 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Facility | None | $1,258.93 | $1,258.93 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,202.26 Typical High $1,995.26 | Professional | None | $660.69 | $1,202.26 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $467.74 | $1,047.13 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $3,467.37 | Professional | None | $812.83 | $1,445.44 | $3,467.37 |
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 $501.19 Median $891.25 Typical High $1,445.44 | Professional | None | $501.19 | $891.25 | $1,445.44 |
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 $234.42 Median $234.42 Typical High $380.19 | Facility | 52 · Reduced service | $234.42 | $234.42 | $380.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $151.36 | Facility | 53 · Discontinued | $93.33 | $93.33 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $114.82 | Facility | 55 · Aftercare only | $69.18 | $69.18 | $114.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $75.86 | Facility | 56 · Pre-op care only | $46.77 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $234.42 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $93.33 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $69.18 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $46.77 | $61.66 | $75.86 |
Where North Dakota sits
The same service costs 3.0 times more in Colorado 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
CO $5,106MD $1,697
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.