How much rates vary
Facilitymedian $132 · 10th to 90th $115 to $269Professionalmedian $251 · 10th to 90th $135 to $347
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 $114.82 Median $131.83 Typical High $245.47 | Facility | None | $114.82 | $131.83 | $245.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | 54 · Surgery only | $87.10 | $87.10 | $100.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $93.33 | Facility | 78 · Unplanned return to OR | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $204.17 | Professional | None | $114.82 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $112.20 | Professional | 54 · Surgery only | $87.10 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $93.33 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $81.28 | $93.33 | $104.71 |
BCBS North Dakota Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $346.74 | Professional | None | $213.80 | $269.15 | $346.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $257.04 Median $323.59 Typical High $416.87 | Professional | 22 · Increased work | $257.04 | $323.59 | $416.87 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $398.11 Typical High $512.86 | Professional | 50 · Both sides | $323.59 | $398.11 | $512.86 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | 54 · Surgery only | $151.36 | $186.21 | $239.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $162.18 | $199.53 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Facility | None | $234.42 | $234.42 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $371.54 | Professional | None | $131.83 | $257.04 | $371.54 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $165.96 Typical High $269.15 | Facility | None | $114.82 | $165.96 | $269.15 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $1,412.54 | Professional | None | $138.04 | $257.04 | $1,412.54 |
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 $120.23 Median $218.78 Typical High $263.03 | Professional | None | $120.23 | $218.78 | $263.03 |
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 $57.54 Median $58.88 Typical High $66.07 | Facility | 52 · Reduced service | $57.54 | $58.88 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $26.30 | Facility | 53 · Discontinued | $23.44 | $23.44 | $26.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.95 | Facility | 55 · Aftercare only | $17.38 | $17.38 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.75 Typical High $13.18 | Facility | 56 · Pre-op care only | $11.48 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $23.44 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $15.14 |
Where North Dakota sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 7th of 51
$245
AK $490FL $117
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.