How much rates vary
Facilitymedian $562 · 10th to 90th $182 to $1,202Professionalmedian $562 · 10th to 90th $245 to $1,445
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 $181.97 Median $524.81 Typical High $562.34 | Facility | None | $181.97 | $524.81 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $426.58 | Facility | 54 · Surgery only | $138.04 | $138.04 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $524.81 Typical High $562.34 | Professional | None | $181.97 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $138.04 | $389.05 | $426.58 |
BCBS North Dakota Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $1,445.44 | Professional | None | $323.59 | $512.86 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $389.05 Median $616.60 Typical High $1,737.80 | Professional | 22 · Increased work | $389.05 | $616.60 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $363.08 Typical High $1,000.00 | Professional | 54 · Surgery only | $229.09 | $363.08 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $1,479.11 | Professional | None | $263.03 | $588.84 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $562.34 Typical High $1,698.24 | Facility | None | $181.97 | $562.34 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $4,073.80 | Professional | None | $512.86 | $1,023.29 | $4,073.80 |
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 $190.55 Median $467.74 Typical High $1,071.52 | Professional | None | $190.55 | $467.74 | $1,071.52 |
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 $91.20 Median $91.20 Typical High $281.84 | Facility | 52 · Reduced service | $91.20 | $91.20 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $114.82 | Facility | 53 · Discontinued | $37.15 | $37.15 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $85.11 | Facility | 55 · Aftercare only | $27.54 | $27.54 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $56.23 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $91.20 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $37.15 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $27.54 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $18.62 | $52.48 | $56.23 |
Where North Dakota sits
The same service costs 4.8 times more in Colorado than in Maryland. 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 $4,327MD $911
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.