How much rates vary
Facilitymedian $240 · 10th to 90th $135 to $407Professionalmedian $447 · 10th to 90th $240 to $603
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 $239.88 Typical High $239.88 | Facility | None | $213.80 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $169.82 Typical High $181.97 | Facility | 54 · Surgery only | $162.18 | $169.82 | $181.97 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $158.49 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $151.36 | $158.49 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $257.04 | Professional | None | $194.98 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $190.55 | Professional | 54 · Surgery only | $162.18 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $177.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $616.60 | Professional | None | $380.19 | $467.74 | $616.60 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $562.34 Typical High $741.31 | Professional | 22 · Increased work | $457.09 | $562.34 | $741.31 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $707.95 Typical High $912.01 | Professional | 50 · Both sides | $575.44 | $707.95 | $912.01 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $331.13 Typical High $426.58 | Professional | 54 · Surgery only | $269.15 | $331.13 | $426.58 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Facility | None | $416.87 | $416.87 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $467.74 Typical High $660.69 | Professional | None | $218.78 | $467.74 | $660.69 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $407.38 | Facility | None | $125.89 | $239.88 | $407.38 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $1,584.89 | Professional | None | $251.19 | $446.68 | $1,584.89 |
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 $478.63 | Professional | None | $223.87 | $398.11 | $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 $107.15 Median $112.20 Typical High $120.23 | Facility | 52 · Reduced service | $107.15 | $112.20 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $48.98 | Facility | 53 · Discontinued | $42.66 | $45.71 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $36.31 | Facility | 55 · Aftercare only | $32.36 | $33.88 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $23.99 | Facility | 56 · Pre-op care only | $21.38 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $107.15 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $42.66 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.38 | $23.99 | $25.70 |
Where North Dakota sits
The same service costs 4.3 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· 6th of 51
$437
AK $871FL $204
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.