How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $832Professionalmedian $708 · 10th to 90th $200 to $1,445
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 $144.54 Median $707.95 Typical High $707.95 | Facility | None | $144.54 | $707.95 | $707.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $524.81 | Facility | 54 · Surgery only | $109.65 | $114.82 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $281.84 Typical High $812.83 | Professional | None | $128.82 | $281.84 | $812.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $1,412.54 | Professional | None | $257.04 | $380.19 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $302.00 Median $457.09 Typical High $1,698.24 | Professional | 22 · Increased work | $302.00 | $457.09 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $977.24 | Professional | 54 · Surgery only | $177.83 | $263.03 | $977.24 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $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 $239.88 Median $851.14 Typical High $1,778.28 | Professional | None | $239.88 | $851.14 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $831.76 | Facility | None | $125.89 | $251.19 | $831.76 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,380.38 Typical High $1,513.56 | Professional | None | $707.95 | $1,380.38 | $1,513.56 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $154.88 Median $645.65 Typical High $1,479.11 | Professional | None | $154.88 | $645.65 | $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 $72.44 Median $77.62 Typical High $354.81 | Facility | 52 · Reduced service | $72.44 | $77.62 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $30.90 Typical High $141.25 | Facility | 53 · Discontinued | $28.84 | $30.90 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $104.71 | Facility | 55 · Aftercare only | $21.88 | $23.44 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $70.79 | Facility | 56 · Pre-op care only | $14.45 | $15.49 | $70.79 |
Where North Dakota sits
The same service costs 17.4 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 $9,157MT $526
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.