How much rates vary
Facilitymedian $339 · 10th to 90th $224 to $1,202Professionalmedian $525 · 10th to 90th $331 to $871
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 $223.87 Median $331.13 Typical High $338.84 | Facility | None | $223.87 | $331.13 | $338.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $257.04 | Facility | 54 · Surgery only | $169.82 | $169.82 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $338.84 | Professional | None | $204.17 | $223.87 | $338.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $870.96 | Professional | None | $389.05 | $575.44 | $870.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $691.83 Typical High $1,047.13 | Professional | 22 · Increased work | $467.74 | $691.83 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $398.11 Typical High $616.60 | Professional | 54 · Surgery only | $275.42 | $398.11 | $616.60 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $426.58 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $295.12 | $426.58 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Facility | None | $575.44 | $575.44 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $891.25 | Professional | None | $354.81 | $575.44 | $891.25 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $478.63 Typical High $1,202.26 | Facility | None | $223.87 | $478.63 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $1,621.81 | Professional | None | $354.81 | $602.56 | $1,621.81 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $645.65 | Professional | None | $239.88 | $426.58 | $645.65 |
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 $112.20 Median $112.20 Typical High $169.82 | Facility | 52 · Reduced service | $112.20 | $112.20 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $67.61 | Facility | 53 · Discontinued | $44.67 | $44.67 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $51.29 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $33.88 | Facility | 56 · Pre-op care only | $22.39 | $22.39 | $33.88 |
Where North Dakota sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.