How much rates vary
Facilitymedian $295 · 10th to 90th $174 to $2,570Professionalmedian $437 · 10th to 90th $257 to $676
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 $173.78 Median $257.04 Typical High $501.19 | Facility | None | $173.78 | $257.04 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $190.55 | Facility | 54 · Surgery only | $131.83 | $131.83 | $190.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $123.03 | $123.03 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $295.12 | Professional | None | $169.82 | $204.17 | $295.12 |
BCBS North Dakota Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $676.08 | Professional | None | $346.74 | $467.74 | $676.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $416.87 Median $562.34 Typical High $812.83 | Professional | 22 · Increased work | $416.87 | $562.34 | $812.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $331.13 Typical High $478.63 | Professional | 54 · Surgery only | $245.47 | $331.13 | $478.63 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $263.03 | $354.81 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Facility | None | $446.68 | $446.68 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $707.95 | Professional | None | $288.40 | $467.74 | $707.95 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $2,511.89 | Facility | None | $173.78 | $371.54 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $1,318.26 | Professional | None | $263.03 | $457.09 | $1,318.26 |
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 $186.21 Median $331.13 Typical High $489.78 | Professional | None | $186.21 | $331.13 | $489.78 |
4 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 $87.10 Median $87.10 Typical High $125.89 | Facility | 52 · Reduced service | $87.10 | $87.10 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $51.29 | Facility | 53 · Discontinued | $34.67 | $34.67 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $38.02 | Facility | 55 · Aftercare only | $26.30 | $26.30 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $25.70 | Facility | 56 · Pre-op care only | $17.38 | $17.38 | $25.70 |
Where North Dakota sits
The same service costs 9.3 times more in Colorado than in Montana. 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
CO $5,912MT $637
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.