How much rates vary
Facilitymedian $251 · 10th to 90th $59 to $468Professionalmedian $148 · 10th to 90th $98 to $324
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 $58.88 Median $323.59 Typical High $588.84 | Facility | None | $58.88 | $323.59 | $588.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $83.18 | Facility | 54 · Surgery only | $43.65 | $43.65 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $114.82 | Professional | None | $58.88 | $95.50 | $114.82 |
BCBS North Dakota Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $380.19 | Facility | None | $213.80 | $263.03 | $380.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $331.13 | Professional | None | $114.82 | $169.82 | $331.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $138.04 Median $204.17 Typical High $398.11 | Professional | 22 · Increased work | $138.04 | $204.17 | $398.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $120.23 Typical High $229.09 | Professional | 54 · Surgery only | $79.43 | $120.23 | $229.09 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $128.82 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $85.11 | $128.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $223.87 | Facility | None | $194.98 | $194.98 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $169.82 Typical High $302.00 | Professional | None | $91.20 | $169.82 | $302.00 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $190.55 Typical High $338.84 | Facility | None | $58.88 | $190.55 | $338.84 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $501.19 | Professional | None | $114.82 | $204.17 | $501.19 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $213.80 | Professional | None | $63.10 | $114.82 | $213.80 |
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 $29.51 Median $29.51 Typical High $54.95 | Facility | 52 · Reduced service | $29.51 | $29.51 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $21.88 | Facility | 53 · Discontinued | $11.75 | $11.75 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $16.60 | Facility | 55 · Aftercare only | $8.71 | $8.71 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $10.96 | Facility | 56 · Pre-op care only | $5.89 | $5.89 | $10.96 |
Where North Dakota sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.