How much rates vary
Facilitymedian $468 · 10th to 90th $324 to $1,413Professionalmedian $724 · 10th to 90th $447 to $1,122
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 $323.59 Median $467.74 Typical High $467.74 | Facility | None | $323.59 | $467.74 | $467.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $346.74 | Facility | 54 · Surgery only | $245.47 | $245.47 | $346.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $46.77 | Facility | 56 · Pre-op care only | $32.36 | $32.36 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $229.09 | $229.09 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $512.86 | Professional | None | $323.59 | $416.87 | $512.86 |
BCBS North Dakota Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,148.15 | Professional | None | $602.56 | $831.76 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $724.44 Median $1,000.00 Typical High $1,380.38 | Professional | 22 · Increased work | $724.44 | $1,000.00 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,230.27 Typical High $1,698.24 | Professional | 50 · Both sides | $891.25 | $1,230.27 | $1,698.24 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $575.44 Typical High $794.33 | Professional | 54 · Surgery only | $416.87 | $575.44 | $794.33 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $83.18 Typical High $114.82 | Professional | 56 · Pre-op care only | $60.26 | $83.18 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $616.60 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Facility | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $1,479.11 | Professional | None | $512.86 | $831.76 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $660.69 Typical High $1,412.54 | Facility | None | $323.59 | $660.69 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $1,000.00 | Professional | None | $478.63 | $851.14 | $1,000.00 |
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 $331.13 Median $602.56 Typical High $912.01 | Professional | None | $331.13 | $602.56 | $912.01 |
3 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 $162.18 Median $162.18 Typical High $234.42 | Facility | 52 · Reduced service | $162.18 | $162.18 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $93.33 | Facility | 53 · Discontinued | $64.57 | $64.57 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $69.18 | Facility | 55 · Aftercare only | $48.98 | $48.98 | $69.18 |
Where North Dakota sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.