How much rates vary
Facilitymedian $589 · 10th to 90th $407 to $2,570Professionalmedian $955 · 10th to 90th $589 to $1,479
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 $407.38 Median $588.84 Typical High $588.84 | Facility | None | $407.38 | $588.84 | $588.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $436.52 | Facility | 54 · Surgery only | $302.00 | $309.03 | $436.52 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $58.88 | Facility | 56 · Pre-op care only | $40.74 | $41.69 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $281.84 | $288.40 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $588.84 | Professional | None | $398.11 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $436.52 | Professional | 54 · Surgery only | $302.00 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $407.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,479.11 | Professional | None | $776.25 | $1,071.52 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $933.25 Median $1,288.25 Typical High $1,778.28 | Professional | 22 · Increased work | $933.25 | $1,288.25 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,584.89 Typical High $2,238.72 | Professional | 50 · Both sides | $1,174.90 | $1,584.89 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $741.31 Typical High $1,047.13 | Professional | 54 · Surgery only | $549.54 | $741.31 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $147.91 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $147.91 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $794.33 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $588.84 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Facility | None | $1,000.00 | $1,000.00 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $1,584.89 | Professional | None | $549.54 | $977.24 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $2,511.89 | Facility | None | $407.38 | $831.76 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $3,090.30 | Professional | None | $602.56 | $1,096.48 | $3,090.30 |
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 $426.58 Median $776.25 Typical High $1,148.15 | Professional | None | $426.58 | $776.25 | $1,148.15 |
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 $204.17 Median $208.93 Typical High $295.12 | Facility | 52 · Reduced service | $204.17 | $208.93 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $117.49 | Facility | 53 · Discontinued | $81.28 | $83.18 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $87.10 | Facility | 55 · Aftercare only | $60.26 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $60.26 | $77.62 | $89.13 |
Where North Dakota sits
The same service costs 4.4 times more in Colorado 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
CO $6,491MT $1,489
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.