How much rates vary
Facilitymedian $331 · 10th to 90th $200 to $2,570Professionalmedian $457 · 10th to 90th $288 to $813
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 $331.13 Typical High $331.13 | Facility | None | $199.53 | $331.13 | $331.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $245.47 | Facility | 54 · Surgery only | $151.36 | $151.36 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $338.84 | Professional | None | $199.53 | $275.42 | $338.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $812.83 | Professional | None | $354.81 | $524.81 | $812.83 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $426.58 Median $616.60 Typical High $977.24 | Professional | 22 · Increased work | $426.58 | $616.60 | $977.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $251.19 | $363.08 | $562.34 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $389.05 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $269.15 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Facility | None | $575.44 | $575.44 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,047.13 | Professional | None | $316.23 | $562.34 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $478.63 Typical High $2,511.89 | Facility | None | $199.53 | $478.63 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $707.95 | Professional | None | $309.03 | $524.81 | $707.95 |
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 $208.93 Median $371.54 Typical High $588.84 | Professional | None | $208.93 | $371.54 | $588.84 |
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 $100.00 Median $100.00 Typical High $162.18 | Facility | 52 · Reduced service | $100.00 | $100.00 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $66.07 | Facility | 53 · Discontinued | $40.74 | $40.74 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $48.98 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $33.11 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $33.11 |
Where North Dakota sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.