How much rates vary
Facilitymedian $2,818 · 10th to 90th $631 to $4,677Professionalmedian $1,202 · 10th to 90th $631 to $1,622
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 $630.96 Median $630.96 Typical High $5,011.87 | Facility | None | $630.96 | $630.96 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $933.25 | Professional | None | $588.84 | $630.96 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $524.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,380.38 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | 22 · Increased work | $1,288.25 | $1,659.59 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $741.31 | $954.99 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $162.18 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $162.18 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $794.33 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,047.13 | $1,047.13 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,659.59 | Professional | None | $676.08 | $1,174.90 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,818.38 Typical High $4,570.88 | Facility | None | $630.96 | $2,818.38 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,071.52 Typical High $4,677.35 | Professional | None | $512.86 | $1,071.52 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $512.86 Median $870.96 Typical High $1,258.93 | Professional | None | $512.86 | $870.96 | $1,258.93 |
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 $295.12 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $295.12 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $112.20 |
Where North Dakota sits
The same service costs 5.4 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 $11,084MT $2,070
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.