How much rates vary
Facilitymedian $437 · 10th to 90th $398 to $776Professionalmedian $871 · 10th to 90th $427 to $1,175
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 $436.52 Typical High $436.52 | Facility | None | $398.11 | $436.52 | $436.52 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $323.59 | Facility | 54 · Surgery only | $295.12 | $316.23 | $323.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $43.65 | Facility | 56 · Pre-op care only | $39.81 | $41.69 | $43.65 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $275.42 | $295.12 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $467.74 | Professional | None | $363.08 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,174.90 | Professional | None | $776.25 | $977.24 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $933.25 Median $1,174.90 Typical High $1,412.54 | Professional | 22 · Increased work | $933.25 | $1,174.90 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,479.11 Typical High $1,778.28 | Professional | 50 · Both sides | $1,174.90 | $1,479.11 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $537.03 | $691.83 | $831.76 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $77.62 | $97.72 | $117.49 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $575.44 | $741.31 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Facility | None | $776.25 | $776.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,318.26 | Professional | None | $426.58 | $912.01 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $776.25 | Facility | None | $398.11 | $489.78 | $776.25 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $3,090.30 | Professional | None | $446.68 | $831.76 | $3,090.30 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $891.25 | Professional | None | $416.87 | $741.31 | $891.25 |
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 $199.53 Median $208.93 Typical High $213.80 | Facility | 52 · Reduced service | $199.53 | $208.93 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $87.10 | Facility | 53 · Discontinued | $79.43 | $83.18 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $64.57 | Facility | 55 · Aftercare only | $60.26 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $69.18 |
Where North Dakota sits
The same service costs 4.7 times more in Colorado than in Delaware. 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 $4,364DE $926
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.