How much rates vary
Facilitymedian $603 · 10th to 90th $457 to $2,570Professionalmedian $955 · 10th to 90th $589 to $1,413
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 $457.09 Median $588.84 Typical High $588.84 | Facility | None | $457.09 | $588.84 | $588.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $436.52 | Facility | 54 · Surgery only | $338.84 | $363.08 | $436.52 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $58.88 | Facility | 56 · Pre-op care only | $45.71 | $48.98 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $316.23 | $338.84 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $630.96 | Professional | None | $457.09 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $436.52 |
BCBS North Dakota Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,445.44 | Professional | None | $776.25 | $1,047.13 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $724.44 Typical High $1,000.00 | Professional | 54 · Surgery only | $549.54 | $724.44 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $104.71 Typical High $144.54 | Professional | 56 · Pre-op care only | $77.62 | $104.71 | $144.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $776.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $588.84 | $776.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Facility | None | $1,023.29 | $1,023.29 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,096.48 Typical High $1,621.81 | Professional | None | $512.86 | $1,096.48 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $2,511.89 | Facility | None | $457.09 | $831.76 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,071.52 Typical High $1,380.38 | Professional | None | $588.84 | $1,071.52 | $1,380.38 |
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 $467.74 Median $851.14 Typical High $1,148.15 | Professional | None | $467.74 | $851.14 | $1,148.15 |
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 $229.09 Median $239.88 Typical High $295.12 | Facility | 52 · Reduced service | $229.09 | $239.88 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $117.49 | Facility | 53 · Discontinued | $91.20 | $97.72 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $87.10 | Facility | 55 · Aftercare only | $67.61 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $251.19 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $95.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $933.25 Median $1,258.93 Typical High $1,737.80 | Professional | 22 · Increased work | $933.25 | $1,258.93 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,548.82 Typical High $2,137.96 | Professional | 50 · Both sides | $1,174.90 | $1,548.82 | $2,137.96 |
Where North Dakota sits
The same service costs 4.0 times more in Oklahoma than in West 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.
Physician feeFacility fee
OK $5,056WV $1,262
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.