How much rates vary
Facilitymedian $741 · 10th to 90th $178 to $2,570Professionalmedian $741 · 10th to 90th $251 to $1,738
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 $177.83 Median $724.44 Typical High $741.31 | Facility | None | $177.83 | $724.44 | $741.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $562.34 | Facility | 54 · Surgery only | $131.83 | $131.83 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $831.76 | Professional | None | $177.83 | $316.23 | $831.76 |
BCBS North Dakota Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $1,778.28 | Professional | None | $302.00 | $457.09 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $363.08 Median $537.03 Typical High $2,137.96 | Professional | 22 · Increased work | $363.08 | $537.03 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $316.23 Typical High $1,230.27 | Professional | 54 · Surgery only | $213.80 | $316.23 | $1,230.27 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $338.84 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $229.09 | $338.84 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,258.93 | $1,258.93 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $758.58 Typical High $2,238.72 | Professional | None | $251.19 | $758.58 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $741.31 Typical High $2,511.89 | Facility | None | $177.83 | $741.31 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,258.93 Typical High $1,621.81 | Professional | None | $758.58 | $1,258.93 | $1,621.81 |
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 $181.97 Median $588.84 Typical High $1,348.96 | Professional | None | $181.97 | $588.84 | $1,348.96 |
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 $87.10 Median $87.10 Typical High $371.54 | Facility | 52 · Reduced service | $87.10 | $87.10 | $371.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $147.91 | Facility | 53 · Discontinued | $35.48 | $35.48 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $112.20 | Facility | 55 · Aftercare only | $26.30 | $26.30 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $74.13 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $74.13 |
Where North Dakota sits
The same service costs 4.0 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 $5,041MT $1,267
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.