How much rates vary
Facilitymedian $437 · 10th to 90th $170 to $1,318Professionalmedian $437 · 10th to 90th $195 to $1,175
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 $169.82 Median $426.58 Typical High $436.52 | Facility | None | $169.82 | $426.58 | $436.52 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $331.13 | Facility | 54 · Surgery only | $128.82 | $128.82 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $660.69 | Professional | None | $169.82 | $251.19 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $316.23 Typical High $363.08 | Professional | 54 · Surgery only | $128.82 | $316.23 | $363.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $1,174.90 | Professional | None | $302.00 | $478.63 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $363.08 Median $575.44 Typical High $1,412.54 | Professional | 22 · Increased work | $363.08 | $575.44 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $338.84 Typical High $812.83 | Professional | 54 · Surgery only | $213.80 | $338.84 | $812.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $363.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $229.09 | $363.08 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Facility | None | $776.25 | $776.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $478.63 Typical High $1,122.02 | Professional | None | $229.09 | $478.63 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $630.96 Typical High $1,698.24 | Facility | None | $169.82 | $630.96 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $707.95 Typical High $3,311.31 | Professional | None | $338.84 | $707.95 | $3,311.31 |
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 $177.83 Median $354.81 Typical High $794.33 | Professional | None | $177.83 | $354.81 | $794.33 |
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 $85.11 Median $85.11 Typical High $218.78 | Facility | 52 · Reduced service | $85.11 | $85.11 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $87.10 | Facility | 53 · Discontinued | $33.88 | $33.88 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $66.07 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $43.65 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $85.11 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $33.88 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $25.70 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $16.98 | $41.69 | $47.86 |
Where North Dakota sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.