How much rates vary
Facilitymedian $631 · 10th to 90th $437 to $2,754Professionalmedian $1,047 · 10th to 90th $603 to $1,622
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 $436.52 Median $602.56 Typical High $616.60 | Facility | None | $436.52 | $602.56 | $616.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $446.68 | Facility | 54 · Surgery only | $323.59 | $323.59 | $446.68 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $60.26 | Facility | 56 · Pre-op care only | $43.65 | $43.65 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $302.00 | $302.00 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $616.60 | Professional | None | $371.54 | $467.74 | $616.60 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,621.81 | Professional | None | $870.96 | $1,174.90 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,047.13 Median $1,412.54 Typical High $1,949.84 | Professional | 22 · Increased work | $1,047.13 | $1,412.54 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $831.76 Typical High $1,148.15 | Professional | 54 · Surgery only | $616.60 | $831.76 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $117.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $87.10 | $117.49 | $162.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $891.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $660.69 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Facility | None | $1,071.52 | $1,071.52 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,698.24 | Professional | None | $776.25 | $1,148.15 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,047.13 Typical High $2,754.23 | Facility | None | $436.52 | $1,047.13 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $3,311.31 | Professional | None | $630.96 | $1,047.13 | $3,311.31 |
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 $457.09 Median $812.83 Typical High $1,122.02 | Professional | None | $457.09 | $812.83 | $1,122.02 |
3 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 $218.78 Median $218.78 Typical High $302.00 | Facility | 52 · Reduced service | $218.78 | $218.78 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $120.23 | Facility | 53 · Discontinued | $87.10 | $87.10 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $89.13 | Facility | 55 · Aftercare only | $64.57 | $64.57 | $89.13 |
Where North Dakota sits
The same service costs 5.2 times more in Colorado 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
CO $6,580WV $1,277
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.