How much rates vary
Facilitymedian $363 · 10th to 90th $129 to $1,202Professionalmedian $363 · 10th to 90th $155 to $977
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 $128.82 Median $363.08 Typical High $363.08 | Facility | None | $128.82 | $363.08 | $363.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $269.15 | Facility | 54 · Surgery only | $97.72 | $97.72 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $436.52 | Professional | None | $128.82 | $181.97 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $97.72 | $263.03 | $288.40 |
BCBS North Dakota Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $977.24 | Professional | None | $234.42 | $371.54 | $977.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $281.84 Median $446.68 Typical High $1,174.90 | Professional | 22 · Increased work | $281.84 | $446.68 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $691.83 | Professional | 54 · Surgery only | $162.18 | $257.04 | $691.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $275.42 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $173.78 | $275.42 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Facility | None | $660.69 | $660.69 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $954.99 | Professional | None | $162.18 | $363.08 | $954.99 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $537.03 Typical High $1,698.24 | Facility | None | $128.82 | $537.03 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $575.44 Typical High $2,818.38 | Professional | None | $257.04 | $575.44 | $2,818.38 |
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 $134.90 Median $288.40 Typical High $630.96 | Professional | None | $134.90 | $288.40 | $630.96 |
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 $64.57 Median $64.57 Typical High $181.97 | Facility | 52 · Reduced service | $64.57 | $64.57 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $72.44 | Facility | 53 · Discontinued | $25.70 | $25.70 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $53.70 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $36.31 | Facility | 56 · Pre-op care only | $12.88 | $12.88 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $64.57 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $25.70 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $19.50 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.88 | $34.67 | $38.90 |
Where North Dakota sits
The same service costs 5.7 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 $4,090MT $722
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.