How much rates vary
Facilitymedian $316 · 10th to 90th $79 to $1,995Professionalmedian $186 · 10th to 90th $107 to $417
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 $79.43 Median $177.83 Typical High $3,235.94 | Facility | None | $79.43 | $177.83 | $3,235.94 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $131.83 | Facility | 54 · Surgery only | $58.88 | $58.88 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $239.88 | Professional | None | $74.13 | $158.49 | $239.88 |
BCBS North Dakota Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
BCBS North Dakota Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $426.58 | Professional | None | $125.89 | $194.98 | $426.58 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $147.91 Median $229.09 Typical High $512.86 | Professional | 22 · Increased work | $147.91 | $229.09 | $512.86 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $288.40 Typical High $645.65 | Professional | 50 · Both sides | $186.21 | $288.40 | $645.65 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $134.90 Typical High $302.00 | Professional | 54 · Surgery only | $87.10 | $134.90 | $302.00 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $144.54 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $93.33 | $144.54 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $354.81 | Facility | None | $309.03 | $309.03 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $549.54 | Professional | None | $123.03 | $245.47 | $549.54 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $309.03 Typical High $1,479.11 | Facility | None | $79.43 | $309.03 | $1,479.11 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $380.19 | Professional | None | $177.83 | $323.59 | $380.19 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $346.74 | Professional | None | $81.28 | $177.83 | $346.74 |
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 $39.81 Median $39.81 Typical High $89.13 | Facility | 52 · Reduced service | $39.81 | $39.81 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $35.48 | Facility | 53 · Discontinued | $15.85 | $15.85 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $26.30 | Facility | 55 · Aftercare only | $11.75 | $11.75 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $17.78 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $17.78 |
Where North Dakota sits
The same service costs 9.7 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 $4,351MT $447
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.