How much rates vary
Facilitymedian $427 · 10th to 90th $355 to $2,570Professionalmedian $759 · 10th to 90th $447 to $1,072
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 $354.81 Median $426.58 Typical High $426.58 | Facility | None | $354.81 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $323.59 | Facility | 54 · Surgery only | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $426.58 | Professional | None | $354.81 | $363.08 | $426.58 |
BCBS North Dakota Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $741.31 Median $954.99 Typical High $1,288.25 | Professional | 22 · Increased work | $741.31 | $954.99 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,202.26 Typical High $1,621.81 | Professional | 50 · Both sides | $933.25 | $1,202.26 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $562.34 | $758.58 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $467.74 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Facility | None | $724.44 | $724.44 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,148.15 | Professional | None | $501.19 | $812.83 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $724.44 Typical High $2,511.89 | Facility | None | $354.81 | $724.44 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $933.25 | Professional | None | $446.68 | $794.33 | $933.25 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $851.14 | Professional | None | $371.54 | $645.65 | $851.14 |
4 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 $177.83 Median $177.83 Typical High $213.80 | Facility | 52 · Reduced service | $177.83 | $177.83 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $85.11 | Facility | 53 · Discontinued | $70.79 | $70.79 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $64.57 | Facility | 55 · Aftercare only | $52.48 | $52.48 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $42.66 | Facility | 56 · Pre-op care only | $35.48 | $35.48 | $42.66 |
Where North Dakota sits
The same service costs 6.3 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 $7,350MT $1,166
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.