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 $707.95 Median $707.95 Typical High $8,511.38 | Facility | None | $707.95 | $707.95 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,412.54 | Professional | None | $660.69 | $707.95 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $1,047.13 | Professional | 54 · Surgery only | $501.19 | $537.03 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $141.25 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $977.24 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,479.11 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,380.38 Median $1,778.28 Typical High $2,089.30 | Professional | 22 · Increased work | $1,380.38 | $1,778.28 | $2,089.30 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $794.33 | $1,023.29 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $147.91 Typical High $173.78 | Professional | 56 · Pre-op care only | $114.82 | $147.91 | $173.78 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $851.14 | $1,096.48 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Facility | None | $1,202.26 | $1,202.26 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $1,905.46 | Professional | None | $741.31 | $1,318.26 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,570.88 | Facility | None | $707.95 | $2,818.38 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $10,964.78 | Professional | None | $616.60 | $1,258.93 | $10,964.78 |
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 $616.60 Median $977.24 Typical High $1,445.44 | Professional | None | $616.60 | $977.24 | $1,445.44 |
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 $331.13 Median $354.81 Typical High $707.95 | Professional | 52 · Reduced service | $331.13 | $354.81 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $281.84 | Professional | 53 · Discontinued | $134.90 | $144.54 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $208.93 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $208.93 |
Where North Dakota sits
The same service costs 6.3 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· 8th of 51
$1,318
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.