How much rates vary
Facilitymedian $617 · 10th to 90th $347 to $2,570Professionalmedian $1,072 · 10th to 90th $617 to $2,570
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 $346.74 Median $616.60 Typical High $616.60 | Facility | None | $346.74 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $467.74 | Facility | 54 · Surgery only | $263.03 | $295.12 | $467.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $245.47 | $275.42 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $831.76 | Professional | None | $346.74 | $457.09 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $549.54 | Professional | 54 · Surgery only | $263.03 | $338.84 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $2,630.27 | Professional | None | $851.14 | $1,258.93 | $2,630.27 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,023.29 Median $1,513.56 Typical High $3,090.30 | Professional | 22 · Increased work | $1,023.29 | $1,513.56 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,905.46 Typical High $3,890.45 | Professional | 50 · Both sides | $1,258.93 | $1,905.46 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $891.25 Typical High $1,819.70 | Professional | 54 · Surgery only | $588.84 | $891.25 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $954.99 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $630.96 | $954.99 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Facility | None | $1,513.56 | $1,513.56 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $2,398.83 | Professional | None | $562.34 | $1,071.52 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $3,630.78 | Professional | None | $645.65 | $1,202.26 | $3,630.78 |
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 $371.54 Median $691.83 Typical High $1,202.26 | Professional | None | $371.54 | $691.83 | $1,202.26 |
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 $173.78 Median $194.98 Typical High $309.03 | Facility | 52 · Reduced service | $173.78 | $194.98 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $125.89 | Facility | 53 · Discontinued | $69.18 | $77.62 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $93.33 | Facility | 55 · Aftercare only | $52.48 | $58.88 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $61.66 | Facility | 56 · Pre-op care only | $34.67 | $38.90 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $229.09 Typical High $363.08 | Professional | 52 · Reduced service | $173.78 | $229.09 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $144.54 | Professional | 53 · Discontinued | $69.18 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $109.65 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $72.44 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $72.44 |
Where North Dakota sits
The same service costs 3.2 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 $4,968MT $1,567
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.