How much rates vary
Facilitymedian $275 · 10th to 90th $138 to $1,202Professionalmedian $324 · 10th to 90th $209 to $646
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 $138.04 Median $275.42 Typical High $275.42 | Facility | None | $138.04 | $275.42 | $275.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $109.65 Typical High $204.17 | Facility | 54 · Surgery only | $102.33 | $109.65 | $204.17 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $102.33 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $95.50 | $102.33 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $288.40 | Professional | None | $138.04 | $151.36 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $114.82 Typical High $213.80 | Professional | 54 · Surgery only | $102.33 | $114.82 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $107.15 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $95.50 | $107.15 | $199.53 |
BCBS North Dakota Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $645.65 | Professional | None | $239.88 | $354.81 | $645.65 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $288.40 Median $426.58 Typical High $776.25 | Professional | 22 · Increased work | $288.40 | $426.58 | $776.25 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $537.03 Typical High $977.24 | Professional | 50 · Both sides | $354.81 | $537.03 | $977.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $251.19 Typical High $457.09 | Professional | 54 · Surgery only | $165.96 | $251.19 | $457.09 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $269.15 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $177.83 | $269.15 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $741.31 | Professional | None | $204.17 | $380.19 | $741.31 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $380.19 Typical High $1,202.26 | Facility | None | $138.04 | $380.19 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $1,023.29 | Professional | None | $275.42 | $501.19 | $1,023.29 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $537.03 | Professional | None | $141.25 | $275.42 | $537.03 |
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 $69.18 Median $74.13 Typical High $134.90 | Facility | 52 · Reduced service | $69.18 | $74.13 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $29.51 Typical High $54.95 | Facility | 53 · Discontinued | $27.54 | $29.51 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $21.88 Typical High $40.74 | Facility | 55 · Aftercare only | $20.42 | $21.88 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $27.54 | Facility | 56 · Pre-op care only | $13.80 | $14.79 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $75.86 Typical High $144.54 | Professional | 52 · Reduced service | $69.18 | $75.86 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.20 Typical High $57.54 | Professional | 53 · Discontinued | $27.54 | $30.20 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.91 Typical High $43.65 | Professional | 55 · Aftercare only | $20.42 | $22.91 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.14 Typical High $28.84 | Professional | 56 · Pre-op care only | $13.80 | $15.14 | $28.84 |
Where North Dakota sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 16th of 51
$316
AK $851VA $182
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.