How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $457.09 Median $457.09 Typical High $1,995.26 | Facility | None | $457.09 | $457.09 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $501.19 | Professional | None | $446.68 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $331.13 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $346.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,148.15 | Professional | None | $758.58 | $977.24 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $912.01 Median $1,174.90 Typical High $1,380.38 | Professional | 22 · Increased work | $912.01 | $1,174.90 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $524.81 | $691.83 | $812.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $75.86 | $97.72 | $114.82 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $741.31 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $562.34 | $741.31 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Facility | None | $794.33 | $794.33 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $870.96 Typical High $1,258.93 | Professional | None | $436.52 | $870.96 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $1,778.28 | Facility | None | $457.09 | $794.33 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $758.58 Typical High $3,388.44 | Professional | None | $380.19 | $758.58 | $3,388.44 |
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 $363.08 Median $602.56 Typical High $870.96 | Professional | None | $363.08 | $602.56 | $870.96 |
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 Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $89.13 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $74.13 |
Where North Dakota sits
The same service costs 6.2 times more in Alaska than in Texas. 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· 9th of 51
$851
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.