How much rates vary
Facilitymedian $646 · 10th to 90th $182 to $3,162Professionalmedian $646 · 10th to 90th $275 to $1,413
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 $645.65 Typical High $645.65 | Facility | None | $181.97 | $645.65 | $645.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $147.91 Typical High $478.63 | Facility | 54 · Surgery only | $138.04 | $147.91 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $660.69 | Professional | None | $181.97 | $208.93 | $660.69 |
BCBS North Dakota Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $1,412.54 | Professional | None | $316.23 | $467.74 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $380.19 Median $562.34 Typical High $1,698.24 | Professional | 22 · Increased work | $380.19 | $562.34 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $331.13 Typical High $977.24 | Professional | 54 · Surgery only | $218.78 | $331.13 | $977.24 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Facility | None | $1,000.00 | $1,000.00 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $870.96 Typical High $1,819.70 | Professional | None | $302.00 | $870.96 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $645.65 Typical High $3,090.30 | Facility | None | $181.97 | $645.65 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,380.38 | Professional | None | $645.65 | $1,096.48 | $1,380.38 |
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 $588.84 Typical High $1,174.90 | Professional | None | $190.55 | $588.84 | $1,174.90 |
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 $97.72 Typical High $316.23 | Facility | 52 · Reduced service | $91.20 | $97.72 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $128.82 | Facility | 53 · Discontinued | $36.31 | $38.90 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $95.50 | Facility | 55 · Aftercare only | $27.54 | $29.51 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $64.57 | Facility | 56 · Pre-op care only | $18.20 | $19.50 | $64.57 |
Where North Dakota sits
The same service costs 6.9 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 $7,377MT $1,063
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.