How much rates vary
Facilitymedian $617 · 10th to 90th $398 to $2,570Professionalmedian $933 · 10th to 90th $525 to $1,514
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 $616.60 Typical High $616.60 | Facility | None | $398.11 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $467.74 | Facility | 54 · Surgery only | $302.00 | $309.03 | $467.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $61.66 | Facility | 56 · Pre-op care only | $39.81 | $40.74 | $61.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $281.84 | $288.40 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $758.58 | Professional | None | $380.19 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $302.00 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $436.52 |
BCBS North Dakota Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,513.56 | Professional | None | $776.25 | $1,047.13 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $741.31 Typical High $1,071.52 | Professional | 54 · Surgery only | $537.03 | $741.31 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $104.71 Typical High $151.36 | Professional | 56 · Pre-op care only | $77.62 | $104.71 | $151.36 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,047.13 | $1,047.13 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,659.59 | Professional | None | $562.34 | $1,023.29 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $870.96 Typical High $2,511.89 | Facility | None | $398.11 | $870.96 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $3,090.30 | Professional | None | $630.96 | $1,174.90 | $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 $416.87 Median $758.58 Typical High $1,258.93 | Professional | None | $416.87 | $758.58 | $1,258.93 |
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 $204.17 Typical High $309.03 | Facility | 52 · Reduced service | $199.53 | $204.17 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $123.03 | Facility | 53 · Discontinued | $81.28 | $83.18 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $93.33 | Facility | 55 · Aftercare only | $60.26 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $251.19 Typical High $309.03 | Professional | 52 · Reduced service | $199.53 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $123.03 | Professional | 53 · Discontinued | $81.28 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $60.26 | $75.86 | $93.33 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $933.25 Median $1,258.93 Typical High $1,819.70 | Professional | 22 · Increased work | $933.25 | $1,258.93 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,584.89 Typical High $2,290.87 | Professional | 50 · Both sides | $1,148.15 | $1,584.89 | $2,290.87 |
Where North Dakota sits
The same service costs 6.5 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 $9,949MT $1,532
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.