How much rates vary
Facilitymedian $617 · 10th to 90th $72 to $1,698Professionalmedian $617 · 10th to 90th $89 to $1,349
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 $72.44 Median $616.60 Typical High $616.60 | Facility | None | $72.44 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $457.09 | Facility | 54 · Surgery only | $53.70 | $53.70 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $389.05 Typical High $1,047.13 | Professional | None | $70.79 | $389.05 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $295.12 Typical High $457.09 | Professional | 54 · Surgery only | $53.70 | $295.12 | $457.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $1,348.96 | Professional | None | $120.23 | $194.98 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $144.54 Median $234.42 Typical High $1,621.81 | Professional | 22 · Increased work | $144.54 | $234.42 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $933.25 | Professional | 54 · Surgery only | $85.11 | $138.04 | $933.25 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $147.91 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $91.20 | $147.91 | $1,000.00 |
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 $93.33 Median $588.84 Typical High $1,445.44 | Professional | None | $93.33 | $588.84 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $616.60 Typical High $1,698.24 | Facility | None | $72.44 | $616.60 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,047.13 Typical High $4,265.80 | Professional | None | $512.86 | $1,047.13 | $4,265.80 |
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 $74.13 Median $389.05 Typical High $1,096.48 | Professional | None | $74.13 | $389.05 | $1,096.48 |
7 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 $35.48 Median $35.48 Typical High $302.00 | Facility | 52 · Reduced service | $35.48 | $35.48 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $123.03 | Facility | 53 · Discontinued | $14.45 | $14.45 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $91.20 | Facility | 55 · Aftercare only | $10.72 | $10.72 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $194.98 Typical High $302.00 | Professional | 52 · Reduced service | $35.48 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $77.62 Typical High $123.03 | Professional | 53 · Discontinued | $14.45 | $77.62 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $58.88 Typical High $91.20 | Professional | 55 · Aftercare only | $10.72 | $58.88 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $38.90 Typical High $61.66 | Professional | 56 · Pre-op care only | $7.08 | $38.90 | $61.66 |
Where North Dakota sits
The same service costs 5.6 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 $4,728MT $843
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.