How much rates vary
Facilitymedian $263 · 10th to 90th $74 to $1,622Professionalmedian $257 · 10th to 90th $89 to $724
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 $74.13 Median $263.03 Typical High $269.15 | Facility | None | $74.13 | $263.03 | $269.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $194.98 | Facility | 54 · Surgery only | $56.23 | $56.23 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $537.03 | Professional | None | $74.13 | $213.80 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $56.23 | $194.98 | $208.93 |
BCBS North Dakota Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $724.44 | Professional | None | $141.25 | $218.78 | $724.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $169.82 Median $257.04 Typical High $870.96 | Professional | 22 · Increased work | $169.82 | $257.04 | $870.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $501.19 | Professional | 54 · Surgery only | $100.00 | $151.36 | $501.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $162.18 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $107.15 | $162.18 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $691.83 | Professional | None | $100.00 | $234.42 | $691.83 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $263.03 Typical High $1,202.26 | Facility | None | $74.13 | $263.03 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $2,041.74 | Professional | None | $223.87 | $407.38 | $2,041.74 |
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 $70.79 Median $186.21 Typical High $457.09 | Professional | None | $70.79 | $186.21 | $457.09 |
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 $37.15 Median $37.15 Typical High $128.82 | Facility | 52 · Reduced service | $37.15 | $37.15 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $52.48 | Facility | 53 · Discontinued | $14.79 | $14.79 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $38.90 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $26.30 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $128.82 Typical High $141.25 | Professional | 52 · Reduced service | $37.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $51.29 Typical High $56.23 | Professional | 53 · Discontinued | $14.79 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $38.90 Typical High $41.69 | Professional | 55 · Aftercare only | $11.22 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.41 | $25.70 | $28.18 |
Where North Dakota sits
The same service costs 9.0 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 $4,579MT $507
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.