How much rates vary
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 $478.63 Median $630.96 Typical High $630.96 | Facility | None | $478.63 | $630.96 | $630.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $467.74 | Facility | 54 · Surgery only | $363.08 | $380.19 | $467.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $63.10 | Facility | 56 · Pre-op care only | $47.86 | $51.29 | $63.10 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $338.84 | $354.81 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $676.08 | Professional | None | $478.63 | $524.81 | $676.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,513.56 | Professional | None | $831.76 | $1,096.48 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,000.00 Median $1,318.26 Typical High $1,819.70 | Professional | 22 · Increased work | $1,000.00 | $1,318.26 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $588.84 | $776.25 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $109.65 Typical High $151.36 | Professional | 56 · Pre-op care only | $83.18 | $109.65 | $151.36 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $831.76 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $630.96 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Facility | None | $1,071.52 | $1,071.52 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,659.59 | Professional | None | $724.44 | $1,148.15 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $4,265.80 | Facility | None | $478.63 | $870.96 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $1,348.96 | Professional | None | $645.65 | $1,174.90 | $1,348.96 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,288.25 | Professional | None | $489.78 | $891.25 | $1,288.25 |
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 $239.88 Median $257.04 Typical High $316.23 | Facility | 52 · Reduced service | $239.88 | $257.04 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $125.89 | Facility | 53 · Discontinued | $95.50 | $102.33 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $95.50 | Facility | 55 · Aftercare only | $72.44 | $75.86 | $95.50 |
Where North Dakota sits
The same service costs 5.0 times more in Alaska than in Utah. 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.
North Dakota· 11th of 51
$1,023
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.