How much rates vary
Facilitymedian $3,162 · 10th to 90th $166 to $5,495Professionalmedian $3,162 · 10th to 90th $224 to $8,710
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 $165.96 Median $2,691.53 Typical High $3,162.28 | Facility | None | $165.96 | $2,691.53 | $3,162.28 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $2,344.23 | Facility | 54 · Surgery only | $125.89 | $125.89 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $4,466.84 | Professional | None | $162.18 | $257.04 | $4,466.84 |
BCBS North Dakota Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $8,709.64 | Professional | None | $281.84 | $426.58 | $8,709.64 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $338.84 Median $512.86 Typical High $10,471.29 | Professional | 22 · Increased work | $338.84 | $512.86 | $10,471.29 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $302.00 Typical High $6,165.95 | Professional | 54 · Surgery only | $199.53 | $302.00 | $6,165.95 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $323.59 Typical High $6,606.93 | Professional | 78 · Unplanned return to OR | $213.80 | $323.59 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,623.41 | Facility | None | $4,897.79 | $4,897.79 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $4,168.69 Typical High $8,912.51 | Professional | None | $269.15 | $4,168.69 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $3,162.28 Typical High $5,495.41 | Facility | None | $165.96 | $3,162.28 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $3,162.28 Median $6,760.83 Typical High $7,585.78 | Professional | None | $3,162.28 | $6,760.83 | $7,585.78 |
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 $173.78 Median $2,290.87 Typical High $7,585.78 | Professional | None | $173.78 | $2,290.87 | $7,585.78 |
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 $83.18 Median $83.18 Typical High $1,584.89 | Facility | 52 · Reduced service | $83.18 | $83.18 | $1,584.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $630.96 | Facility | 53 · Discontinued | $33.11 | $33.11 | $630.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $467.74 | Facility | 55 · Aftercare only | $25.12 | $25.12 | $467.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $316.23 | Facility | 56 · Pre-op care only | $16.60 | $16.60 | $316.23 |
Where North Dakota sits
The same service costs 4.3 times more in Oklahoma than in Maine. 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 $14,688ME $3,415
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.