How much rates vary
Facilitymedian $200 · 10th to 90th $115 to $1,202Professionalmedian $269 · 10th to 90th $132 to $525
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 $114.82 Median $199.53 Typical High $199.53 | Facility | None | $114.82 | $199.53 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $89.13 Typical High $151.36 | Facility | 54 · Surgery only | $85.11 | $89.13 | $151.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $83.18 Typical High $141.25 | Facility | 78 · Unplanned return to OR | $79.43 | $83.18 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $346.74 | Professional | None | $114.82 | $199.53 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $151.36 Typical High $169.82 | Professional | 54 · Surgery only | $85.11 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $141.25 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $79.43 | $141.25 | $158.49 |
BCBS North Dakota Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $524.81 | Professional | None | $223.87 | $331.13 | $524.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $269.15 Median $398.11 Typical High $630.96 | Professional | 22 · Increased work | $269.15 | $398.11 | $630.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $363.08 | Professional | 54 · Surgery only | $158.49 | $229.09 | $363.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $245.47 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $169.82 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $316.23 Typical High $549.54 | Professional | None | $131.83 | $316.23 | $549.54 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $309.03 Typical High $1,202.26 | Facility | None | $114.82 | $309.03 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $1,621.81 | Professional | None | $177.83 | $363.08 | $1,621.81 |
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 $112.20 Median $208.93 Typical High $398.11 | Professional | None | $112.20 | $208.93 | $398.11 |
8 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 $57.54 Median $60.26 Typical High $100.00 | Facility | 52 · Reduced service | $57.54 | $60.26 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $39.81 | Facility | 53 · Discontinued | $22.91 | $23.99 | $39.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $30.20 | Facility | 55 · Aftercare only | $17.38 | $17.78 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $19.95 | Facility | 56 · Pre-op care only | $11.48 | $12.02 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $57.54 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $22.91 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $17.38 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $22.39 |
Where North Dakota sits
The same service costs 9.8 times more in Colorado than in North Dakota. 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 $4,589ND $469
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.