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 $831.76 Median $831.76 Typical High $6,456.54 | Facility | None | $831.76 | $831.76 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $977.24 | Professional | None | $776.25 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $691.83 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,621.81 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,513.56 Median $1,949.84 Typical High $2,344.23 | Professional | 22 · Increased work | $1,513.56 | $1,949.84 | $2,344.23 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $891.25 | $1,148.15 | $1,348.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $125.89 | $162.18 | $194.98 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $954.99 | $1,230.27 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,584.89 | Facility | None | $1,380.38 | $1,380.38 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $2,187.76 | Professional | None | $831.76 | $1,548.82 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $2,818.38 Typical High $4,570.88 | Facility | None | $831.76 | $2,818.38 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,479.11 Typical High $7,079.46 | Professional | None | $707.95 | $1,479.11 | $7,079.46 |
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 $691.83 Median $1,096.48 Typical High $1,698.24 | Professional | None | $691.83 | $1,096.48 | $1,698.24 |
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 $389.05 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $389.05 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $147.91 |
Where North Dakota sits
The same service costs 6.5 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· 10th of 51
$1,479
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.