How much rates vary
Facilitymedian $427 · 10th to 90th $132 to $1,288Professionalmedian $427 · 10th to 90th $178 to $977
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 $131.83 Median $426.58 Typical High $645.65 | Facility | None | $131.83 | $426.58 | $645.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $316.23 | Facility | 54 · Surgery only | $100.00 | $100.00 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $346.74 Typical High $676.08 | Professional | None | $104.71 | $346.74 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $123.03 Typical High $316.23 | Professional | 54 · Surgery only | $95.50 | $123.03 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $891.25 | Professional | None | $223.87 | $338.84 | $891.25 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $269.15 Median $407.38 Typical High $1,071.52 | Professional | 22 · Increased work | $269.15 | $407.38 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $234.42 Typical High $616.60 | Professional | 54 · Surgery only | $158.49 | $234.42 | $616.60 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $251.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $169.82 | $251.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $758.58 | Facility | None | $645.65 | $645.65 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $426.58 Typical High $1,023.29 | Professional | None | $194.98 | $426.58 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $426.58 Typical High $1,288.25 | Facility | None | $131.83 | $426.58 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $954.99 Typical High $1,412.54 | Professional | None | $426.58 | $954.99 | $1,412.54 |
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 $138.04 Median $363.08 Typical High $1,047.13 | Professional | None | $138.04 | $363.08 | $1,047.13 |
8 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 $66.07 Median $66.07 Typical High $213.80 | Facility | 52 · Reduced service | $66.07 | $66.07 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $85.11 | Facility | 53 · Discontinued | $26.30 | $26.30 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $64.57 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $42.66 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $83.18 Typical High $213.80 | Professional | 52 · Reduced service | $63.10 | $83.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $85.11 | Professional | 53 · Discontinued | $25.12 | $33.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $64.57 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $42.66 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $42.66 |
Where North Dakota sits
The same service costs 5.1 times more in Colorado than in North Dakota. 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 $4,353ND $853
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.