How much rates vary
Facilitymedian $646 · 10th to 90th $398 to $2,570Professionalmedian $832 · 10th to 90th $513 to $1,288
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 $398.11 Median $537.03 Typical High $645.65 | Facility | None | $398.11 | $537.03 | $645.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $478.63 | Facility | 54 · Surgery only | $295.12 | $295.12 | $478.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $64.57 | Facility | 56 · Pre-op care only | $39.81 | $39.81 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $275.42 | $275.42 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $645.65 | Professional | None | $346.74 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $478.63 | Professional | 54 · Surgery only | $263.03 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $64.57 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $309.03 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $245.47 | $309.03 | $446.68 |
BCBS North Dakota Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,288.25 | Professional | None | $645.65 | $870.96 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $616.60 Typical High $912.01 | Professional | 54 · Surgery only | $446.68 | $616.60 | $912.01 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $87.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $64.57 | $87.10 | $128.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $660.69 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $478.63 | $660.69 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Facility | None | $912.01 | $912.01 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $1,445.44 | Professional | None | $489.78 | $870.96 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $2,511.89 | Facility | None | $398.11 | $741.31 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $2,570.40 | Professional | None | $660.69 | $1,174.90 | $2,570.40 |
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 $416.87 Median $758.58 Typical High $1,230.27 | Professional | None | $416.87 | $758.58 | $1,230.27 |
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 $199.53 Median $199.53 Typical High $323.59 | Facility | 52 · Reduced service | $199.53 | $199.53 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $128.82 | Facility | 53 · Discontinued | $79.43 | $79.43 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $95.50 | Facility | 55 · Aftercare only | $58.88 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $223.87 Typical High $323.59 | Professional | 52 · Reduced service | $173.78 | $223.87 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $89.13 Typical High $128.82 | Professional | 53 · Discontinued | $69.18 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $95.50 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $95.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $776.25 Median $1,047.13 Typical High $1,548.82 | Professional | 22 · Increased work | $776.25 | $1,047.13 | $1,548.82 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,318.26 Typical High $1,949.84 | Professional | 50 · Both sides | $954.99 | $1,318.26 | $1,949.84 |
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 $6,451MT $1,460
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.