How much rates vary
Facilitymedian $501 · 10th to 90th $324 to $2,630Professionalmedian $759 · 10th to 90th $417 to $1,230
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 $323.59 Median $501.19 Typical High $501.19 | Facility | None | $323.59 | $501.19 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $380.19 | Facility | 54 · Surgery only | $245.47 | $251.19 | $380.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $50.12 | Facility | 56 · Pre-op care only | $32.36 | $33.11 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $229.09 | $234.42 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $602.56 | Professional | None | $316.23 | $426.58 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $245.47 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $229.09 | $288.40 | $354.81 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
BCBS North Dakota Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,230.27 | Professional | None | $630.96 | $851.14 | $1,230.27 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $741.31 Median $1,023.29 Typical High $1,479.11 | Professional | 22 · Increased work | $741.31 | $1,023.29 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $588.84 Typical High $851.14 | Professional | 54 · Surgery only | $436.52 | $588.84 | $851.14 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $123.03 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $123.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $630.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $467.74 | $630.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Facility | None | $851.14 | $851.14 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $1,348.96 | Professional | None | $478.63 | $831.76 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $2,511.89 | Facility | None | $323.59 | $707.95 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $2,691.53 | Professional | None | $512.86 | $933.25 | $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 $338.84 Median $616.60 Typical High $1,000.00 | Professional | None | $338.84 | $616.60 | $1,000.00 |
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 $162.18 Median $165.96 Typical High $251.19 | Facility | 52 · Reduced service | $162.18 | $165.96 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $100.00 | Facility | 53 · Discontinued | $66.07 | $66.07 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $75.86 | Facility | 55 · Aftercare only | $48.98 | $50.12 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $162.18 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $61.66 | $75.86 |
Where North Dakota sits
The same service costs 6.4 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 $6,390WV $1,003
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.