How much rates vary
Facilitymedian $1,995 · 10th to 90th $575 to $3,236Professionalmedian $1,122 · 10th to 90th $575 to $1,514
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $575.44 Median $575.44 Typical High $6,456.54 | Facility | None | $575.44 | $575.44 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $741.31 | Professional | None | $549.54 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $489.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,288.25 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,202.26 Median $1,548.82 Typical High $1,819.70 | Professional | 22 · Increased work | $1,202.26 | $1,548.82 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $691.83 | $912.01 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $151.36 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $741.31 | $977.24 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Facility | None | $1,000.00 | $1,000.00 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,548.82 | Professional | None | $616.60 | $1,096.48 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $1,995.26 Typical High $3,235.94 | Facility | None | $575.44 | $1,995.26 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,000.00 Typical High $4,365.16 | Professional | None | $478.63 | $1,000.00 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,148.15 | Professional | None | $478.63 | $794.33 | $1,148.15 |
3 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 Professional Modifier 52 · Reduced service Typical Low $275.42 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $104.71 |
Where North Dakota sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.