How much rates vary
Facilitymedian $145 · 10th to 90th $102 to $759Professionalmedian $224 · 10th to 90th $141 to $347
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 $102.33 Median $144.54 Typical High $144.54 | Facility | None | $102.33 | $144.54 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $81.28 Typical High $109.65 | Facility | 54 · Surgery only | $77.62 | $81.28 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $154.88 | Professional | None | $102.33 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $77.62 | $85.11 | $114.82 |
BCBS North Dakota Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $208.93 Median $288.40 Typical High $416.87 | Professional | 22 · Increased work | $208.93 | $288.40 | $416.87 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $354.81 Typical High $524.81 | Professional | 50 · Both sides | $257.04 | $354.81 | $524.81 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $120.23 | $165.96 | $245.47 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $128.82 | $177.83 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $288.40 | Facility | None | $251.19 | $251.19 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $389.05 | Professional | None | $125.89 | $245.47 | $389.05 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $758.58 | Facility | None | $102.33 | $204.17 | $758.58 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $758.58 | Professional | None | $147.91 | $269.15 | $758.58 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $288.40 | Professional | None | $104.71 | $194.98 | $288.40 |
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 $51.29 Median $54.95 Typical High $72.44 | Facility | 52 · Reduced service | $51.29 | $54.95 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $21.88 Typical High $28.84 | Facility | 53 · Discontinued | $20.89 | $21.88 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $21.88 | Facility | 55 · Aftercare only | $15.49 | $16.22 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $14.45 | Facility | 56 · Pre-op care only | $10.23 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $30.90 | Professional | 53 · Discontinued | $20.89 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $15.49 |
Where North Dakota sits
The same service costs 10.9 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 $3,950MT $363
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.