How much rates vary
Facilitymedian $617 · 10th to 90th $186 to $2,570Professionalmedian $468 · 10th to 90th $191 to $891
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 $186.21 Median $331.13 Typical High $3,019.95 | Facility | None | $186.21 | $331.13 | $3,019.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $66.07 Typical High $165.96 | Facility | 53 · Discontinued | $37.15 | $66.07 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $251.19 | Facility | 54 · Surgery only | $138.04 | $151.36 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $630.96 | Professional | None | $181.97 | $331.13 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $89.13 Typical High $213.80 | Professional | 53 · Discontinued | $37.15 | $89.13 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $173.78 | $263.03 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,348.96 | $2,290.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | None | $660.69 | $794.33 | $954.99 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $630.96 Typical High $1,071.52 | Professional | 22 · Increased work | $398.11 | $630.96 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | 53 · Discontinued | $288.40 | $371.54 | $436.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $363.08 Typical High $616.60 | Professional | 54 · Surgery only | $229.09 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $676.08 | Facility | None | $588.84 | $588.84 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $467.74 | Professional | None | $194.98 | $302.00 | $467.74 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $562.34 Typical High $1,778.28 | Facility | None | $186.21 | $562.34 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $2,187.76 | Professional | None | $338.84 | $562.34 | $2,187.76 |
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 $190.55 Median $354.81 Typical High $630.96 | Professional | None | $190.55 | $354.81 | $630.96 |
5 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 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $50.12 | Facility | 55 · Aftercare only | $27.54 | $30.20 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $33.11 | Facility | 56 · Pre-op care only | $18.62 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $95.50 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $34.67 |
Where North Dakota sits
The same service costs 4.3 times more in Connecticut 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
CT $2,910WV $682
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.