How much rates vary
Facilitymedian $1,905 · 10th to 90th $339 to $5,370Professionalmedian $794 · 10th to 90th $316 to $5,248
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 $338.84 Median $1,905.46 Typical High $1,905.46 | Facility | None | $338.84 | $1,905.46 | $1,905.46 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $1,445.44 | Facility | 54 · Surgery only | $257.04 | $257.04 | $1,445.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $1,348.96 | Facility | 78 · Unplanned return to OR | $239.88 | $239.88 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $2,137.96 | Professional | None | $151.36 | $338.84 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $1,548.82 | Professional | 54 · Surgery only | $239.88 | $257.04 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $5,248.07 | Professional | None | $588.84 | $870.96 | $5,248.07 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $1,047.13 Typical High $6,309.57 | Professional | 22 · Increased work | $707.95 | $1,047.13 | $6,309.57 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $616.60 Typical High $3,715.35 | Professional | 54 · Surgery only | $407.38 | $616.60 | $3,715.35 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $660.69 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $436.52 | $660.69 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,168.69 | Facility | None | $3,630.78 | $3,630.78 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $870.96 Typical High $5,754.40 | Professional | None | $302.00 | $870.96 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $1,905.46 Typical High $5,370.32 | Facility | None | $338.84 | $1,905.46 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,905.46 Typical High $7,943.28 | Professional | None | $275.42 | $1,905.46 | $7,943.28 |
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 $263.03 Median $426.58 Typical High $3,630.78 | Professional | None | $263.03 | $426.58 | $3,630.78 |
8 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 $169.82 Median $169.82 Typical High $954.99 | Facility | 52 · Reduced service | $169.82 | $169.82 | $954.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $380.19 | Facility | 53 · Discontinued | $67.61 | $67.61 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $288.40 | Facility | 55 · Aftercare only | $51.29 | $51.29 | $288.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $190.55 | Facility | 56 · Pre-op care only | $33.88 | $33.88 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $169.82 Typical High $1,023.29 | Professional | 52 · Reduced service | $158.49 | $169.82 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $407.38 | Professional | 53 · Discontinued | $63.10 | $67.61 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $309.03 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $204.17 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $204.17 |
Where North Dakota sits
The same service costs 13.1 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 $15,603MT $1,192
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.