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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,023.29 | Professional | None | $912.01 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $724.44 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,995.26 | $2,344.23 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,819.70 Median $2,344.23 Typical High $2,818.38 | Professional | 22 · Increased work | $1,819.70 | $2,344.23 | $2,818.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,380.38 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,071.52 | $1,380.38 | $1,621.81 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $199.53 Typical High $234.42 | Professional | 56 · Pre-op care only | $151.36 | $199.53 | $234.42 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,479.11 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,621.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,778.28 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $2,884.03 Typical High $4,570.88 | Facility | None | $977.24 | $2,884.03 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $9,120.11 | Professional | None | $851.14 | $1,584.89 | $9,120.11 |
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 $812.83 Median $1,288.25 Typical High $1,819.70 | Professional | None | $812.83 | $1,288.25 | $1,819.70 |
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 $457.09 Median $489.78 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $154.88 |
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· 11th of 51
$1,738
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.