How much rates vary
Facilitymedian $891 · 10th to 90th $200 to $1,698Professionalmedian $891 · 10th to 90th $257 to $2,042
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 $199.53 Median $891.25 Typical High $891.25 | Facility | None | $199.53 | $891.25 | $891.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $676.08 | Facility | 54 · Surgery only | $151.36 | $151.36 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $831.76 Typical High $1,548.82 | Professional | None | $194.98 | $831.76 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $147.91 | $616.60 | $676.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $2,041.74 | Professional | None | $331.13 | $537.03 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $645.65 Typical High $2,454.71 | Professional | 22 · Increased work | $398.11 | $645.65 | $2,454.71 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $380.19 Typical High $1,412.54 | Professional | 54 · Surgery only | $234.42 | $380.19 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $407.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $251.19 | $407.38 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Facility | None | $1,513.56 | $1,513.56 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $707.95 Typical High $2,187.76 | Professional | None | $269.15 | $707.95 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $891.25 Typical High $1,698.24 | Facility | None | $199.53 | $891.25 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,513.56 Typical High $6,456.54 | Professional | None | $794.33 | $1,513.56 | $6,456.54 |
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 $204.17 Median $588.84 Typical High $1,621.81 | Professional | None | $204.17 | $588.84 | $1,621.81 |
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 $100.00 Median $100.00 Typical High $446.68 | Facility | 52 · Reduced service | $100.00 | $100.00 | $446.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $181.97 | Facility | 53 · Discontinued | $39.81 | $39.81 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $134.90 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $89.13 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $416.87 Typical High $446.68 | Professional | 52 · Reduced service | $97.72 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $38.90 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $29.51 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.50 | $83.18 | $89.13 |
Where North Dakota sits
The same service costs 5.2 times more in Colorado than in Maryland. 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 $5,090MD $977
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.