How much rates vary
Facilitymedian $813 · 10th to 90th $182 to $3,236Professionalmedian $813 · 10th to 90th $263 to $1,820
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 $181.97 Median $812.83 Typical High $851.14 | Facility | None | $181.97 | $812.83 | $851.14 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $616.60 | Facility | 54 · Surgery only | $138.04 | $151.36 | $616.60 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $128.82 | $141.25 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $891.25 | Professional | None | $181.97 | $257.04 | $891.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,862.09 | Professional | None | $331.13 | $489.78 | $1,862.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $588.84 Typical High $2,187.76 | Professional | 22 · Increased work | $398.11 | $588.84 | $2,187.76 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $346.74 Typical High $1,288.25 | Professional | 54 · Surgery only | $229.09 | $346.74 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $371.54 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $245.47 | $371.54 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Facility | None | $1,288.25 | $1,288.25 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $1,862.09 | Professional | None | $263.03 | $478.63 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $870.96 Typical High $3,162.28 | Facility | None | $181.97 | $870.96 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,778.28 | Professional | None | $831.76 | $1,348.96 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $190.55 Median $758.58 Typical High $1,479.11 | Professional | None | $190.55 | $758.58 | $1,479.11 |
4 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 $91.20 Median $100.00 Typical High $407.38 | Facility | 52 · Reduced service | $91.20 | $100.00 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $162.18 | Facility | 53 · Discontinued | $37.15 | $39.81 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $123.03 | Facility | 55 · Aftercare only | $27.54 | $30.20 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $81.28 | Facility | 56 · Pre-op care only | $18.20 | $19.95 | $81.28 |
Where North Dakota sits
The same service costs 5.1 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 $7,315MT $1,443
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.