How much rates vary
Facilitymedian $191 · 10th to 90th $132 to $1,698Professionalmedian $295 · 10th to 90th $186 to $468
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 $131.83 Median $186.21 Typical High $190.55 | Facility | None | $131.83 | $186.21 | $190.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $141.25 | Facility | 54 · Surgery only | $97.72 | $97.72 | $141.25 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $131.83 | Facility | 78 · Unplanned return to OR | $91.20 | $91.20 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $223.87 | Professional | None | $131.83 | $186.21 | $223.87 |
BCBS North Dakota Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $489.78 | Professional | None | $245.47 | $338.84 | $489.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $295.12 Median $407.38 Typical High $588.84 | Professional | 22 · Increased work | $295.12 | $407.38 | $588.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $338.84 | Professional | 54 · Surgery only | $169.82 | $239.88 | $338.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Facility | None | $338.84 | $338.84 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $537.03 | Professional | None | $194.98 | $331.13 | $537.03 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $1,202.26 | Facility | None | $131.83 | $281.84 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $407.38 | Professional | None | $194.98 | $338.84 | $407.38 |
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 $134.90 Median $245.47 Typical High $363.08 | Professional | None | $134.90 | $245.47 | $363.08 |
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 $64.57 Median $64.57 Typical High $95.50 | Facility | 52 · Reduced service | $64.57 | $64.57 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $38.02 | Facility | 53 · Discontinued | $26.30 | $26.30 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $28.18 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $19.05 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $19.05 |
Where North Dakota sits
The same service costs 9.9 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 $4,605MT $466
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.