How much rates vary
Facilitymedian $427 · 10th to 90th $126 to $2,570Professionalmedian $427 · 10th to 90th $186 to $1,096
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 $125.89 Median $426.58 Typical High $426.58 | Facility | None | $125.89 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $323.59 | Facility | 54 · Surgery only | $95.50 | $95.50 | $323.59 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $89.13 | $89.13 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $426.58 Typical High $616.60 | Professional | None | $125.89 | $426.58 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $95.50 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $89.13 | $275.42 | $309.03 |
BCBS North Dakota Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $1,122.02 | Professional | None | $239.88 | $371.54 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $288.40 Median $446.68 Typical High $1,348.96 | Professional | 22 · Increased work | $288.40 | $446.68 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $263.03 Typical High $776.25 | Professional | 54 · Surgery only | $169.82 | $263.03 | $776.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $281.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $181.97 | $281.84 | $831.76 |
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 $173.78 Median $457.09 Typical High $1,122.02 | Professional | None | $173.78 | $457.09 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $426.58 Typical High $2,511.89 | Facility | None | $125.89 | $426.58 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $812.83 Typical High $3,311.31 | Professional | None | $363.08 | $812.83 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $123.03 Median $331.13 Typical High $870.96 | Professional | None | $123.03 | $331.13 | $870.96 |
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 $63.10 Median $63.10 Typical High $213.80 | Facility | 52 · Reduced service | $63.10 | $63.10 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $85.11 | Facility | 53 · Discontinued | $25.70 | $25.70 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $64.57 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $42.66 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $63.10 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $79.43 Typical High $89.13 | Professional | 53 · Discontinued | $25.70 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $19.05 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $39.81 Typical High $44.67 | Professional | 56 · Pre-op care only | $12.59 | $39.81 | $44.67 |
Where North Dakota sits
The same service costs 5.6 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 $4,763ND $853
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.