How much rates vary
Facilitymedian $490 · 10th to 90th $355 to $2,570Professionalmedian $813 · 10th to 90th $490 to $1,202
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 $354.81 Median $467.74 Typical High $489.78 | Facility | None | $354.81 | $467.74 | $489.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $371.54 | Facility | 54 · Surgery only | $263.03 | $263.03 | $371.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $48.98 | Facility | 56 · Pre-op care only | $35.48 | $35.48 | $48.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $346.74 | Facility | 78 · Unplanned return to OR | $245.47 | $245.47 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $489.78 | Professional | None | $338.84 | $467.74 | $489.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,202.26 | Professional | None | $630.96 | $870.96 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $758.58 Median $1,047.13 Typical High $1,445.44 | Professional | 22 · Increased work | $758.58 | $1,047.13 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $616.60 Typical High $851.14 | Professional | 54 · Surgery only | $446.68 | $616.60 | $851.14 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $87.10 Typical High $120.23 | Professional | 56 · Pre-op care only | $63.10 | $87.10 | $120.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $660.69 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $478.63 | $660.69 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $977.24 | Facility | None | $851.14 | $851.14 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,348.96 | Professional | None | $588.84 | $870.96 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $691.83 Typical High $2,511.89 | Facility | None | $354.81 | $691.83 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $912.01 Typical High $3,090.30 | Professional | None | $501.19 | $912.01 | $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 $363.08 Median $676.08 Typical High $977.24 | Professional | None | $363.08 | $676.08 | $977.24 |
3 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 $173.78 Median $173.78 Typical High $245.47 | Facility | 52 · Reduced service | $173.78 | $173.78 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $97.72 | Facility | 53 · Discontinued | $70.79 | $70.79 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $74.13 | Facility | 55 · Aftercare only | $52.48 | $52.48 | $74.13 |
Where North Dakota sits
The same service costs 3.9 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 $4,927MT $1,254
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.