How much rates vary
Facilitymedian $550 · 10th to 90th $178 to $2,570Professionalmedian $550 · 10th to 90th $204 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 $177.83 Median $537.03 Typical High $549.54 | Facility | None | $177.83 | $537.03 | $549.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $407.38 | Facility | 54 · Surgery only | $134.90 | $134.90 | $407.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $125.89 | $125.89 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $501.19 Typical High $1,000.00 | Professional | None | $173.78 | $501.19 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $134.90 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $125.89 | $354.81 | $380.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,445.44 | Professional | None | $346.74 | $524.81 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $407.38 Median $630.96 Typical High $1,737.80 | Professional | 22 · Increased work | $407.38 | $630.96 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $371.54 Typical High $1,023.29 | Professional | 54 · Surgery only | $239.88 | $371.54 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $398.11 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $257.04 | $398.11 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Facility | None | $977.24 | $977.24 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $562.34 Typical High $1,412.54 | Professional | None | $223.87 | $562.34 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $562.34 Typical High $2,511.89 | Facility | None | $177.83 | $562.34 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $977.24 Typical High $4,073.80 | Professional | None | $457.09 | $977.24 | $4,073.80 |
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 $173.78 Median $436.52 Typical High $1,071.52 | Professional | None | $173.78 | $436.52 | $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 $89.13 Median $89.13 Typical High $275.42 | Facility | 52 · Reduced service | $89.13 | $89.13 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $109.65 | Facility | 53 · Discontinued | $36.31 | $36.31 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $81.28 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $81.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $54.95 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $89.13 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $36.31 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $26.92 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $17.78 | $50.12 | $54.95 |
Where North Dakota sits
The same service costs 4.4 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 $4,844ND $1,099
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.