How much rates vary
Facilitymedian $589 · 10th to 90th $407 to $2,570Professionalmedian $933 · 10th to 90th $550 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 $407.38 Median $575.44 Typical High $588.84 | Facility | None | $407.38 | $575.44 | $588.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $436.52 | Facility | 54 · Surgery only | $302.00 | $309.03 | $436.52 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $58.88 | Facility | 56 · Pre-op care only | $40.74 | $40.74 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $281.84 | $288.40 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $645.65 | Professional | None | $407.38 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $302.00 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $407.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,380.38 | Professional | None | $776.25 | $1,023.29 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $933.25 Median $1,230.27 Typical High $1,659.59 | Professional | 22 · Increased work | $933.25 | $1,230.27 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $724.44 Typical High $977.24 | Professional | 54 · Surgery only | $537.03 | $724.44 | $977.24 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $102.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $77.62 | $102.33 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $776.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $575.44 | $776.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Facility | None | $977.24 | $977.24 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $1,548.82 | Professional | None | $524.81 | $977.24 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $794.33 Typical High $2,511.89 | Facility | None | $407.38 | $794.33 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,071.52 Typical High $3,090.30 | Professional | None | $588.84 | $1,071.52 | $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 $776.25 Typical High $1,148.15 | Professional | None | $416.87 | $776.25 | $1,148.15 |
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 $204.17 Median $204.17 Typical High $288.40 | Facility | 52 · Reduced service | $204.17 | $204.17 | $288.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $117.49 | Facility | 53 · Discontinued | $81.28 | $83.18 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $87.10 | Facility | 55 · Aftercare only | $61.66 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $204.17 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $87.10 |
Where North Dakota sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.