How much rates vary
Facilitymedian $550 · 10th to 90th $331 to $1,778Professionalmedian $776 · 10th to 90th $479 to $1,413
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 $331.13 Median $537.03 Typical High $2,511.89 | Facility | None | $331.13 | $537.03 | $2,511.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $407.38 | Facility | 54 · Surgery only | $245.47 | $257.04 | $407.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $53.70 | Facility | 56 · Pre-op care only | $33.11 | $33.88 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $229.09 | $239.88 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $724.44 | Professional | None | $316.23 | $489.78 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $245.47 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $229.09 | $288.40 | $389.05 |
BCBS North Dakota Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,412.54 | Professional | None | $645.65 | $891.25 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $776.25 Median $1,071.52 Typical High $1,698.24 | Professional | 22 · Increased work | $776.25 | $1,071.52 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $630.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $446.68 | $630.96 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $89.13 Typical High $141.25 | Professional | 56 · Pre-op care only | $64.57 | $89.13 | $141.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $676.08 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $478.63 | $676.08 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $912.01 Typical High $1,513.56 | Professional | None | $478.63 | $912.01 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $758.58 Typical High $1,778.28 | Facility | None | $331.13 | $758.58 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $2,511.89 | Professional | None | $549.54 | $977.24 | $2,511.89 |
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 $346.74 Median $645.65 Typical High $1,023.29 | Professional | None | $346.74 | $645.65 | $1,023.29 |
6 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 $165.96 Median $169.82 Typical High $269.15 | Facility | 52 · Reduced service | $165.96 | $169.82 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $107.15 | Facility | 53 · Discontinued | $66.07 | $67.61 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $81.28 | Facility | 55 · Aftercare only | $48.98 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $208.93 Typical High $281.84 | Professional | 52 · Reduced service | $165.96 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $112.20 | Professional | 53 · Discontinued | $66.07 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $83.18 | Professional | 55 · Aftercare only | $48.98 | $61.66 | $83.18 |
Where North Dakota sits
The same service costs 4.4 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 $4,828WV $1,100
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.