How much rates vary
Facilitymedian $3,236 · 10th to 90th $550 to $7,413Professionalmedian $1,096 · 10th to 90th $550 to $1,479
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 $549.54 Median $549.54 Typical High $10,000.00 | Facility | None | $549.54 | $549.54 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $1,318.26 | Professional | None | $501.19 | $549.54 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $457.09 |
BCBS North Dakota Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $10,964.78 | Facility | None | $8,317.64 | $8,317.64 | $10,964.78 |
BCBS North Dakota Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,479.11 | Professional | None | $977.24 | $1,258.93 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $676.08 | $870.96 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $147.91 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Facility | None | $933.25 | $933.25 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,479.11 | Professional | None | $588.84 | $1,047.13 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $3,235.94 Typical High $5,754.40 | Facility | None | $549.54 | $3,235.94 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $933.25 Typical High $4,570.88 | Professional | None | $457.09 | $933.25 | $4,570.88 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,495.41 | Facility | None | $3,235.94 | $4,897.79 | $5,495.41 |
United Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,096.48 | Professional | None | $457.09 | $758.58 | $1,096.48 |
5 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 $263.03 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $97.72 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,148.15 Median $1,513.56 Typical High $1,778.28 | Professional | 22 · Increased work | $1,148.15 | $1,513.56 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,862.09 Typical High $2,187.76 | Professional | 50 · Both sides | $1,445.44 | $1,862.09 | $2,187.76 |
Where North Dakota sits
The same service costs 6.0 times more in Wisconsin 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
WI $11,096MT $1,846
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.