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 $616.60 Median $616.60 Typical High $6,456.54 | Facility | None | $616.60 | $616.60 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,230.27 | Professional | None | $575.44 | $616.60 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $426.58 | $524.81 |
BCBS North Dakota Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Professional | None | $954.99 | $1,230.27 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,122.02 Median $1,479.11 Typical High $1,737.80 | Professional | 22 · Increased work | $1,122.02 | $1,479.11 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $660.69 | $851.14 | $1,023.29 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $95.50 | $123.03 | $144.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $707.95 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,047.13 | $1,047.13 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,148.15 Typical High $1,621.81 | Professional | None | $630.96 | $1,148.15 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,818.38 Typical High $4,570.88 | Facility | None | $616.60 | $2,818.38 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,122.02 Typical High $5,888.44 | Professional | None | $524.81 | $1,122.02 | $5,888.44 |
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 $512.86 Median $831.76 Typical High $1,288.25 | Professional | None | $512.86 | $831.76 | $1,288.25 |
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 $288.40 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $112.20 |
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· 9th of 51
$1,122
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.