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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,479.11 | Professional | None | $724.44 | $724.44 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $1,096.48 | Professional | 54 · Surgery only | $537.03 | $549.54 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $147.91 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,584.89 | $1,862.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,445.44 Median $1,862.09 Typical High $2,238.72 | Professional | 22 · Increased work | $1,445.44 | $1,862.09 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $158.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $120.23 | $158.49 | $186.21 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,174.90 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $912.01 | $1,174.90 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,479.11 | Facility | None | $1,288.25 | $1,288.25 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $2,041.74 | Professional | None | $776.25 | $1,445.44 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $4,570.88 | Facility | None | $724.44 | $2,818.38 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,288.25 Typical High $6,760.83 | Professional | None | $616.60 | $1,288.25 | $6,760.83 |
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 $1,023.29 Typical High $1,479.11 | Professional | None | $616.60 | $1,023.29 | $1,479.11 |
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 $354.81 Median $363.08 Typical High $741.31 | Professional | 52 · Reduced service | $354.81 | $363.08 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $295.12 | Professional | 53 · Discontinued | $144.54 | $144.54 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $223.87 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $223.87 |
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
$1,380
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.