How much rates vary
Facilitymedian $245 · 10th to 90th $191 to $759Professionalmedian $437 · 10th to 90th $245 to $661
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 $190.55 Median $245.47 Typical High $245.47 | Facility | None | $190.55 | $245.47 | $245.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $181.97 | Facility | 54 · Surgery only | $141.25 | $141.25 | $181.97 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $131.83 | $131.83 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $251.19 | Professional | None | $190.55 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $177.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $660.69 | Professional | None | $363.08 | $489.78 | $660.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $436.52 Median $588.84 Typical High $794.33 | Professional | 22 · Increased work | $436.52 | $588.84 | $794.33 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $257.04 | $346.74 | $467.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $275.42 | $371.54 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Facility | None | $436.52 | $436.52 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $691.83 | Professional | None | $234.42 | $467.74 | $691.83 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $346.74 Typical High $758.58 | Facility | None | $190.55 | $346.74 | $758.58 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $1,513.56 | Professional | None | $251.19 | $457.09 | $1,513.56 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $478.63 | Professional | None | $194.98 | $363.08 | $478.63 |
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 $93.33 Median $93.33 Typical High $120.23 | Facility | 52 · Reduced service | $93.33 | $93.33 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $48.98 | Facility | 53 · Discontinued | $38.02 | $38.02 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $36.31 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $24.55 | Facility | 56 · Pre-op care only | $19.05 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $93.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $38.02 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $25.12 |
Where North Dakota sits
The same service costs 4.3 times more in Alaska 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· 7th of 51
$427
AK $912KY $214
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.