How much rates vary
Facilitymedian $562 · 10th to 90th $363 to $2,570Professionalmedian $851 · 10th to 90th $479 to $1,380
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 $363.08 Median $549.54 Typical High $562.34 | Facility | None | $363.08 | $549.54 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $416.87 | Facility | 54 · Surgery only | $269.15 | $275.42 | $416.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $56.23 | Facility | 56 · Pre-op care only | $36.31 | $36.31 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $257.04 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $251.19 | $257.04 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $691.83 | Professional | None | $338.84 | $478.63 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $251.19 | $316.23 | $389.05 |
BCBS North Dakota Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,380.38 | Professional | None | $691.83 | $933.25 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $831.76 Median $1,122.02 Typical High $1,659.59 | Professional | 22 · Increased work | $831.76 | $1,122.02 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,412.54 Typical High $2,089.30 | Professional | 50 · Both sides | $1,047.13 | $1,412.54 | $2,089.30 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $645.65 Typical High $954.99 | Professional | 54 · Surgery only | $478.63 | $645.65 | $954.99 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $93.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $69.18 | $93.33 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $512.86 | $691.83 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Facility | None | $933.25 | $933.25 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $912.01 Typical High $1,479.11 | Professional | None | $524.81 | $912.01 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $2,511.89 | Facility | None | $363.08 | $776.25 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,047.13 Typical High $2,691.53 | Professional | None | $575.44 | $1,047.13 | $2,691.53 |
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 $371.54 Median $691.83 Typical High $1,122.02 | Professional | None | $371.54 | $691.83 | $1,122.02 |
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 $181.97 Median $181.97 Typical High $281.84 | Facility | 52 · Reduced service | $181.97 | $181.97 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $112.20 | Facility | 53 · Discontinued | $72.44 | $72.44 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $83.18 | Facility | 55 · Aftercare only | $53.70 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $72.44 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $83.18 |
Where North Dakota sits
The same service costs 4.7 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 $6,438MT $1,383
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.