How much rates vary
Facilitymedian $513 · 10th to 90th $389 to $2,570Professionalmedian $851 · 10th to 90th $513 to $1,259
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 $389.05 Median $489.78 Typical High $512.86 | Facility | None | $389.05 | $489.78 | $512.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $380.19 | Facility | 54 · Surgery only | $295.12 | $295.12 | $380.19 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $275.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $512.86 | Professional | None | $354.81 | $426.58 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,258.93 | Professional | None | $660.69 | $912.01 | $1,258.93 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $1,096.48 Typical High $1,513.56 | Professional | 22 · Increased work | $794.33 | $1,096.48 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $630.96 Typical High $870.96 | Professional | 54 · Surgery only | $467.74 | $630.96 | $870.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $676.08 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $501.19 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Facility | None | $870.96 | $870.96 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,348.96 | Professional | None | $630.96 | $933.25 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $2,511.89 | Facility | None | $389.05 | $707.95 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $2,884.03 | Professional | None | $524.81 | $954.99 | $2,884.03 |
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 $407.38 Median $741.31 Typical High $1,023.29 | Professional | None | $407.38 | $741.31 | $1,023.29 |
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 $194.98 Median $194.98 Typical High $257.04 | Facility | 52 · Reduced service | $194.98 | $194.98 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $102.33 | Facility | 53 · Discontinued | $77.62 | $77.62 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $75.86 | Facility | 55 · Aftercare only | $58.88 | $58.88 | $75.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $51.29 | Facility | 56 · Pre-op care only | $38.90 | $38.90 | $51.29 |
Where North Dakota sits
The same service costs 4.8 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 $6,464MT $1,341
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.